Gastric involvement and Helicobacter pylori in Kaposi's sarcoma

Year 2013, , 43 - 47, 01.08.2013

Aliye Soylu Metin Özaslan Aslı Turgut Erdemir Büşra Karahacıoğlu Özlem Altuntaş Aydın Serdal Çakmak Fatih Güzelbulut Mehmet Salih Gürel

https://doi.org/10.17940/endoskopi.74805

Abstract

Background and Aims:Kaposi's sarcoma usually presents as skin lesions. Since the gastrointestinal tract is rarely involved in Kaposi's sarcoma patients, endoscopists are not familiar with gastric lesions. In the present study, we aimed to evaluate patients with classical Kaposi's sarcoma and acquired immunodeficiency syndrome -associated Kaposi's sarcoma with respect to gastric symptoms, gastric involvement, and the presence of Helicobacter pylori. Materials and Methods:This study included 18 patients with Kaposi's sarcoma. Forty patients, admitted to the outpatient clinic for Helicobacter pylori, were included as the control group. Stage of the disease, therapy, and dermatological and oral examination findings were recorded. All patients were questioned regarding gastric symptoms and underwent upper gastrointestinal endoscopy. Biopsies were taken from areas suspected as having Kaposi's sarcoma involvement and from the corpus and antrum for the presence of Helicobacter pylori, and results were compared with the control group. Results:Among the 18 patients included in the study, 17 (94.4%) of them were male, and the mean age of the patients was 59.3 (39-79) years. Fifteen patients (83.3%) had classical Kaposi's sarcoma, while 3 (16.7%) had acquired immunodeficiency syndrome -associated Kaposi's sarcoma. Of the 5 patients suspected of having Kaposi's sarcoma on upper gastrointestinal endoscopy, the diagnosis of Kaposi's sarcoma was verified in 3 patients histopathologically. The fundus and corpus were involved in 2 patients and the antrum in 1 patient. None of the biopsies taken from areas other than gastric lesions had any findings associated with Kaposi's sarcoma.In general, 10 patients (55.6%) were symptomatic. Two of 3 (66.6%) patients with gastric involvement and 8 of 15 (55.3%) patients without gastric involvement were symptomatic. Helicobacter pylori was positive in 66.6% of all patients with Kaposi's sarcoma and in 52.5% of patients in the control group (p=0.206). Two patients with Kaposi's sarcoma and gastric involvement were positive for Helicobacter pylori, and these patients had oral involvement as well as acquired immunodeficiency syndrome -associated Kaposi's sarcoma, and they were younger. Conclusions:Presence of gastric symptoms was not enough to assume gastric involvement in Kaposi's sarcoma patients. Gastric involvement is more frequent in patients with oral involvement and in those with acquired immunodeficiency syndrome -associated Kaposi's sarcoma. There was no difference between patients with and without Kaposi's sarcoma in terms of Helicobacter pylori positivity.

Keywords

Kaposi's sarcoma, gastric lesion, Helicobacter pylori

Kaposi sarkomunda gastrik tutulum ve Helicobacter pylori

Abstract

Giriş ve Amaç: Kaposi sarkom sıklıkla cilt bulguları ile ortaya çıkar. Gastrointestinal
sistem nadiren tutulduğu için endoskopistler gastrik lezyonlara
aşina değildir. Bu çalışmada klasik Kaposi sarkomu ve kazanılmış immün
yetmezlik sendromu ilişkili Kaposi sarkomu olgularımızı gastrik semptomlar,
gastrik tutulum ve Helicobacter pylori enfeksiyonu birlikteliği açısından değerlendirmeyi amaçladık. Gereç ve Yöntem: Kaposi sarkomu tanısı ile takip
edilen 18 olgu çalışmaya dahil edildi. Kontrol grubu olarak polikliniğe başvuran
ve Helicobacter pylori açısından test edilen 40 olgu çalışmaya dahil edildi.
Kaposi sarkomlu tüm olguların evreleri, aldıkları tedaviler, cilt ve oral muayenesi
kaydedildi. Olguların gastrik yakınmalarının olup olmadığı sorgulandı.
Tüm olgulara gastroduodenoskopi yapıldı. Histopatolojik olarak gastrik tutulum
alanlarından, ayrıca Helicobacter pylori birlikteliği açısından biyopsiler
alındı ve kontrol grubu ile karşılaştırıldı. Bulgular: Kaposi sarkomlu 18 olgunun
%94,4’ü (n=17) erkek ve yaş ortalaması 59,3 (39-79) idi. Olguların 15’i
(%83,3) klasik Kaposi sarkomu, 3’ü (%16,7) kazanılmış immün yetmezlik
sendromu ile ilişkili Kaposi sarkomu idi. Endoskopik olarak Kaposi sarkomu
tanısı olan 5 olgudan 3’ünde tanı histopatolojik olarak doğrulandı. Kaposi
sarkomu tanısı konan olgulardan 2’sinde fundus-korpus, 1’inde ise antrum
tutulumu vardı. Gastrik lezyon bulunmayan bölgelerden alınan biyopsilerde
Kaposi sarkomu ile ilişkili patoloji saptanmadı. Tüm Kaposi sarkomlu olguların
10’u (%55,6), gastrik tutulumlu Kaposi sarkomluların 2’si (%66,6) ve
gastrik tutulum olmayanların 8’i (%55,3) semptomatik idi. Tüm Kaposi sarkomlu
olguların %66,6’sında Helicobacter pylori (+) idi. Kontrol grubunda
ise Helicobacter pylori (+)’liği %52,5 idi (p=0,206). Gastrik tutulumlu olan
Kaposi sarkomlu hastalardan 2’sinde Helicobacter pylori (+)’idi ve bu hastalar
genç, oral tutulumlu ve kazanılmış immün yetmezlik sendromu ilişkiliydi.
Sonuç: Gastrik semptomların varlığı gastrointestinal Kaposi sarkomu tanısı
için yeterli değildir. Oral tutulumu olan olgularda gastrik tutulum daha sıktır.
Gastrik tutulum kazanılmış immün yetmezlik sendromu ile ilişkili Kaposi sarkomunda
daha sıktır. Helicobacter pylori (+)’liği açısından Kaposi sarkomu
olan ve olmayan olgular arasında fark yoktur.

Keywords

Kaposi sarkomu, gastrik lezyon, Helicobacter pylori

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