{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T08:29:51Z","timestamp":1786350591914,"version":"build-2736575974"},"reference-count":9,"publisher":"Walter de Gruyter GmbH","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Objectives<\/jats:title>\n Accurate diagnosis depends on concordance among clinical findings, histopathologic features, and patient context; when these elements diverge, even well-characterized diseases may evade timely recognition.<\/jats:p>\n <\/jats:sec>\n \n Case presentation<\/jats:title>\n We report a case of Kaposi sarcoma (KS) in a 47-year-old woman who presented with a chronic, unilateral, non-violaceous eruption of the left lower extremity. Serial clinical evaluations and biopsies demonstrated dermal fibrosis, vascular congestion, and hemosiderin deposition without the classic histopathologic features typically associated with KS, leading to repeated interpretation as reactive or stasis-related disease. Despite progressive clinical findings, apparent concordance between benign-appearing clinical and histologic features delayed diagnostic reassessment. Ultimately, expert dermatopathology consultation with immunohistochemical staining confirmed KS in the setting of previously unrecognized HIV infection.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This case illustrates how atypical disease biology, false reassurance from partial concordance, fragmented care, and social determinants of health can disrupt diagnostic synthesis and obscure evolving malignancy. When disease behavior contradicts initial interpretations, deliberate reassessment and longitudinal integration of data across encounters and specialties are essential to avoid delayed diagnosis, particularly in patients facing barriers to longitudinal continuity of\u00a0care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1515\/dx-2026-0009","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:55:55Z","timestamp":1786348555000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic concordance and delayed recognition: a case of atypical Kaposi sarcoma"],"prefix":"10.1515","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9598-5991","authenticated-orcid":false,"given":"Hunter","family":"Cohn","sequence":"first","affiliation":[{"name":"Wayne State University School of Medicine , Detroit , MI , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannie","family":"Hennessy","sequence":"additional","affiliation":[{"name":"Northeast Dermatology , Gahanna , OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlin","family":"Schupp","sequence":"additional","affiliation":[{"name":"Northeast Dermatology , Gahanna , OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Cotell","sequence":"additional","affiliation":[{"name":"Northeast Dermatology , Gahanna , OH , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"2026081007555195250_j_dx-2026-0009_ref_001","doi-asserted-by":"crossref","unstructured":"Yarchoan, R, Uldrick, TS. HIV-associated cancers and related diseases. N\u00a0Engl J Med 2018;378:1029\u201341. https:\/\/doi.org\/10.1056\/NEJMra1615896.","DOI":"10.1056\/NEJMra1615896"},{"key":"2026081007555195250_j_dx-2026-0009_ref_002","doi-asserted-by":"crossref","unstructured":"Cesarman, E, Damania, B, Krown, SE, Martin, J, Bower, M, Whitby, D, et al.. Kaposi sarcoma. Nat Rev Dis Primers 2019;5:9. https:\/\/doi.org\/10.1038\/s41572-019-0060-9.","DOI":"10.1038\/s41572-019-0060-9"},{"key":"2026081007555195250_j_dx-2026-0009_ref_003","doi-asserted-by":"crossref","unstructured":"Antman, K, Chang, Y. Kaposi\u2019s sarcoma. N\u00a0Engl J Med 2000;342:1027\u201338. https:\/\/doi.org\/10.1056\/NEJM200004063421407.","DOI":"10.1056\/NEJM200004063421407"},{"key":"2026081007555195250_j_dx-2026-0009_ref_004","doi-asserted-by":"crossref","unstructured":"Grayson, W, Pantanowitz, L. Histological variants of cutaneous Kaposi sarcoma. Diagn Pathol 2008;3:31. https:\/\/doi.org\/10.1186\/1746-1596-3-31.","DOI":"10.1186\/1746-1596-3-31"},{"key":"2026081007555195250_j_dx-2026-0009_ref_005","doi-asserted-by":"crossref","unstructured":"Vangipuram, R, Tyring, SK. Epidemiology of Kaposi sarcoma: review and description of the nonepidemic variant. Int J Dermatol 2019;58:538\u201342. https:\/\/doi.org\/10.1111\/ijd.14080.","DOI":"10.1111\/ijd.14080"},{"key":"2026081007555195250_j_dx-2026-0009_ref_006","doi-asserted-by":"crossref","unstructured":"Kempf, W, Cathomas, G, Burg, G, Tr\u00fceb, RM. Micronodular Kaposi\u2019s sarcoma: a new variant of classic-sporadic Kaposi\u2019s sarcoma. Dermatology 2004;208:255\u20138. https:\/\/doi.org\/10.1159\/000077313.","DOI":"10.1159\/000077313"},{"key":"2026081007555195250_j_dx-2026-0009_ref_007","doi-asserted-by":"crossref","unstructured":"Johnson, EL, Pierpont, YN, Donate, G, Hiro, MH, Mannari, RJ, Strickland, TJ, et al.. Clinical challenge: cutaneous Kaposi\u2019s sarcoma of the lower extremity. Int Wound J 2011;8:163\u20138. https:\/\/doi.org\/10.1111\/j.1742-481X.2010.00763.x.","DOI":"10.1111\/j.1742-481X.2010.00763.x"},{"key":"2026081007555195250_j_dx-2026-0009_ref_008","doi-asserted-by":"crossref","unstructured":"Hao, X, Rubenstein, S, Yim, J, Robles-Sherman, E, Firestone, L, Bannerjee, A, et al.. Clinicopathologic characterization of Kaposi sarcoma on the foot and ankle: analysis of 11 patients seen in our clinics. J\u00a0Am Podiatr Med Assoc 2023;113:21\u2013175. https:\/\/doi.org\/10.7547\/21-175.","DOI":"10.7547\/21-175"},{"key":"2026081007555195250_j_dx-2026-0009_ref_009","unstructured":"National Cancer Institute, Center for Cancer Research. Laboratory of pathology [Internet]. Bethesda (MD): National Institutes of Health. Available from: https:\/\/ccr.cancer.gov\/laboratory-of-pathology."}],"container-title":["Diagnosis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dx-2026-0009\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dx-2026-0009\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T07:55:57Z","timestamp":1786348557000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dx-2026-0009\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,11]]},"references-count":9,"alternative-id":["10.1515\/dx-2026-0009"],"URL":"https:\/\/doi.org\/10.1515\/dx-2026-0009","relation":{},"ISSN":["2194-8011","2194-802X"],"issn-type":[{"value":"2194-8011","type":"print"},{"value":"2194-802X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,11]]}}}