Minireviews
Copyright ©The Author(s) 2017.
World J Hepatol. Feb 8, 2017; 9(4): 171-179
Published online Feb 8, 2017. doi: 10.4254/wjh.v9.i4.171
Table 2 Outcomes in patients with clinically symptomatic hepatic Kaposi sarcoma
Age (yr)SexHIV statusCD4 count (cells/mm3)Liver chemistry profilePathologyTreatmentHospital course + complications
45[63]M(+)192T Bil 19.35 ALP 1309 AST 204 ALT 188 GGT 827HHV-8 PCR VL (+) 24000 copies/mL. Liver biopsy revealed features of KS with spindle cells, extravasation of red blood cells and haemosiderin deposition. IHC staining HHV8 (+)Paclitaxel, MontelukastContinued on chemotherapy. Subsequently developed respiratory and renal failure, anemia and thrombocytopenia from aggressive metastatic KS
36[64]M(+)17PTT 70 (s) ALT 185 T Bil 23Necroscopy showed bile duct proliferation with diffuse fibrosis with lymphohistiocytic infiltrationLiposomal doxorubicinJaundice, renal failure, fulminant liver failure
28[65]M(+)NRNRBiopsy residues of spindle cells lining portal tracts. Immunoperoxidase staining factor VIII (+)Palliative careLiver function continued to decline and patient died from respiratory failure two weeks later
38[66]M(+)< 2001AST 147 ALT 180 ALP 573Gross specimen with fibrous thickening of portal tracts and dark red nodules in periportal areas and diffusely infiltrating liver parenchymaChemotherapy, NOSPartial cutaneous response, died several weeks later
40[4]M(+)NRReportedly, “normal”KS present on biopsy of lymph nodes. US with three 7-12 mm hyperechoic nodules. Periportal groups of dilated blood filled cavernous spaces lined by flat endothelial cells and interspersed of spindle cells. Extravasated erythrocytes and minimal hemosiderin depositsCombination Chemotherapy, NOSComplete remission of cutaneous lesions and reduction in size of two of the lesions with the third not visible. Readmitted six months later for severe relapse of cutaneous KS. Reinitiated chemotherapy with rapid deterioration and death within one month
48[67]M(+)8TBili 20.0 ALP 947 AST 186 ALT 155 INR 1.9Liver biopsy was Cytokeratin-7 and HHV-8 staining positiveGanciclovir and RituximabPresented with jaundice and acute liver injury with a cholestatic pattern, progressed to fulminant hepatic failure and ultimately death
44[68]M(+)CD4/CD8 ratio 0.08AST 153 ALT 124 ALP 1228Laproscopy demonstrated enlarged liver with multiple purple 2-3 mm nodules Biopsy demonstrated spindle cells, vascular slits, extravasated red cells and lymphocytic infiltrationPlatinum based chemotherapy, NOSPrimary hepatic manifestations without cutaneous lesions. Persistent abdominal pain after treatment. Progressed to cutaneous lesions six weeks after treatment. Lost to follow-up