Sarcoma de Kaposi

  • Gerzaín Rodríguez Instituo Nacional de Salud
  • Adriana Motta Hospital Simón Bolívar
Palabras clave: sarcoma de Kaposi, sarcoma de Kaposi en Colombia

Resumen

El sarcoma de Kaposi (SK) es una proliferación multicéntrica de células fusiformes, endoteliales linfáticas, que afecta la piel y las vísceras, inicialmente hiperplásica, reversible y policlonal; en su progresión se hace agresivo, aneuploide, poliploide y letal. Hay 5 variedades epidemiológicas: 1. Clásico: afecta hombres >60 años; 2. Endémico o africano, 3. Por inmunosupresión, en transplantados renales; 4. Epidémico, asociado con el sida y 5. Epidémico, en homosexuales HIV(-).

En Colombia la variedad clásica predominó en hombres (8:1) en 79 pacientes, en un período de 50 años, y representó el 1 x 1000 de los tumores malignos. Cursó con placas y nódulos simétricos que afectaron los pies y las piernas. No conocemos casos colombianos en transplantados; hemos observado dos casos en homosexuales HIV (-) y más de un centenar en pacientes con sida, en el curso de 1O años, 70 de ellos en los últimos cinco años; sólo dos fueron mujeres y ningún caso ocurrió en niños.

El SK en pacientes HIV+ comienza por manchas eritematosas en cualquier sitio. La afección de la cara, los párpados, el tronco y los genitales es común. En la boca se ven placas eritematovioláceas del paladar, encías y la úvula.

El virus herpes 8, la inmunosupresión y el disbalance en la producción de interleuquinas son los factores etiopatogénicos. El HHV-8 está presente en las lesiones de todas las variedades de SK.

La histopatología varía según la lesión clínica: máculas placas o nódulos. Éstos muestran la imagen florida y clásica, consistente en proliferación de células fusiformes con hendiduras entre ellas que contienen eritrocitos.

Los diagnósticos diferenciales son clínicos e histológicos: angiomas, angiodermitis ocre, angiosarcomas, melanomas fusiformes, carcinomas de células fusiformes, leiomiosarcomas y angiomatosis bacilar (AB).

El tratamiento tiene muchas posibilidades y avances. Con vinblastina, bleomicina, doxirrubicina o radioterapia, las opciones en nuestro hospital, hemos obtenido resultados aceptables, unidos al tratamiento antirretroviral.

Biografía del autor/a

Gerzaín Rodríguez, Instituo Nacional de Salud

Jefe Laboratorio de Patología, Instituto Nacional de Salud; Departamento de Patología, Facultad de Medicina, Universidad Nacional de Colombia.

Adriana Motta, Hospital Simón Bolívar

Hospital Simón Bolívar, Facultad de Medicina, Universidad El Bosque.

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Cómo citar
1.
Rodríguez G, Motta A. Sarcoma de Kaposi. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de febrero de 2003 [citado 28 de noviembre de 2022];11(1):31-42. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/613

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Publicado
2003-02-01
Sección
Revisión de tema