Atypical presentation of classic Kaposi's sarcoma
A 77-year-old woman presented to department with a 2-year history of multiple, painful, purple lesions over her left breast. Physical examination showed multiple, violaceous, infiltrated papules, nodules, and plaques on her left mammary gland ( figure), neck, forearms, legs, hands, and feet. She also had axillary and inguinal lymphadenopathy. She had no medical history prior to this problem. Results of biochemical analyses were normal, and the patient was seronegative for HIV and cytomegalovirus. CT scans were normal, and endoscopy and colonoscopy showed no gastrointestinal tract involvement. A skin biopsy specimen taken from the left breast showed a spindle-cell neoplasm, which was positive on immunohistochemical staining for both CD34 and human herpesvirus 8 (HHV-8), which is known more commonly as Kaposi's sarcoma—associated with herpesvirus ( figure)—thus confirming a diagnosis of Kaposi's sarcoma. The patient was referred to an oncology clinic for further treatment.

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