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Pathology Research International
Volume 2012, Article ID 854146, 6 pages
http://dx.doi.org/10.1155/2012/854146
Clinical Study

False-Negative Results of Endoscopic Biopsy in the Diagnosis of Gastrointestinal Kaposi’s Sarcoma in HIV-Infected Patients

1Department of Gastroenterology, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan
2Department of Clinical Pathology, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
3AIDS Clinical Center (ACC), Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
4Department of Infectious Disease, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
5Department of Clinical Research and Informatics, International Clinical Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
6Department of Gastroenterology and Hepatology, Kohnodai Hospital, National Center for Global Health and Medicine, Chiba, Japan

Received 9 August 2012; Revised 29 October 2012; Accepted 29 October 2012

Academic Editor: Piero Tosi

Copyright © 2012 Naoyoshi Nagata et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Kaposi’s sarcoma (KS) is a rare endothelial neoplasm mainly involving the skin, but it is often associated with AIDS. Diagnosis of gastrointestinal (GI) tract KS, a common site of visceral involvement in AIDS, is important, but endoscopic biopsy carries a risk of false-negative results (FNRs) due to its submucosal appearance. This study sought to determine the rate and causes of FNR for endoscopic biopsy of GI-KS lesions. Endoscopic biopsy samples of 116 GI-KS lesions were reviewed retrospectively. All GI-KS lesions were confirmed to be resolved following KS therapy. FNRs were yielded for 41 of the lesions (35.3%). Among upper and lower GI sites, the esophagus was the only site significantly associated with FNRs ( ). Small size (<10 mm) and patches found on endoscopy were significantly associated with FNRs ( ). Findings of submucosal tumor (SMT) with ulceration were significantly associated with true-positive results ( ). In conclusion, FNRs were found in 35.3% of GI-KS lesions and were especially related to the site of the esophagus and endoscopic early stage (small size or patch appearance). An SMT with ulceration may be relatively easy to diagnose on endoscopic biopsy. Caution should be exercised when performing endoscopic biopsy of these lesions in AIDS patients and evaluating the histological features.