Histology: Biopsies of Kaposi’s sarcoma show many characteristic findings. The promontory sign is often seen; it is represented by plump endothelial cells jutting into the lumen of the capillary vessel. Many slit-like spaces are also seen. These spaces represent poorly formed blood vessels, which are thin walled and easily compressed. They are filled with red blood cells. The tumor in general is very vascular, with a predominance of vascular spaces and a large amount of red blood cell extravasation into the dermis.
Treatment: For classic Kaposi’s sarcoma, the mainstay of therapy has been localized radiation treatment. Many other treatments have been advocated, including topical alitretinoin, imiquimod, intralesional vincristine, and interferon. Systemic chemotherapy for disseminated and aggressive forms is indicated and is usually based on a regimen of either vinblastine, paclitaxel, bleomycin, or pegylated liposomal doxorubicin.
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