Lymphoma-like presentation of Kaposi's sarcoma. Three cases without characteristic skin lesions

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Abstract
Three adults with Kaposi''s sarcoma of the lymph nodes showed a clinical picture simulating a malignant lymphoma or a granulomatous disease in the absence of characteristic skin lesions. Fever, weight loss, lymphadenopathy, hepatosplenomegaly, anemia, and hypergamma-globulinemia were the presenting features. Monocytes were increased in the blood and plasma cells in the bone marrow. The occurrence of a nodular pattern suggestive of follicular lymphoma is stressed among the gross findings in the involved lymph nodes. The microscopic features diagnostic of Kaposi''s sarcoma consisted of a peripherally located, vascular spindle-celled tissue and of a more centrally placed, nodular, angiomatous proliferation of vascular channels with rare spindle cells. The accompanying, nonspecific lymph node lesions included a highly vascular follicular hyperplasia and an infiltration with plasma cells. The latter findings may lead to an erroneous diagnosis of plasmacytoma or chronic inflammation.