ENDOSCOPIC ULTRASOUND IN THE DIAGNOSIS AND STAGING OF GASTROINTESTINAL KAPOSIS-SARCOMA

Background and Study Aims: Endoscopic ultrasonography (EUS) has been e valuated for diagnosing and staging of a variety of gastrointestinal t urners, but there are no data on EUS in Kaposi's sarcoma (KS). The aim of the present study was to evaluate the role of EUS in addition to e ndoscopy in the diagnosis and staging of patients with established or suspected upper gastrointestinal KS. Patients and Methods: 22 male acq uired immune deficiency syndrome (AIDS) patients were prospectively st udied, three of them before and after chemotherapy with liposomal doxo rubicin. The features of gastrointestinal KS were recorded, and EUS wa s assessed for diagnosis in endoscopically negative or inconclusive ca ses, and for staging in endoscopically visible KS lesions. Results: Th e typical EUS feature of KS was a hypoechoic and nonhomogeneous lesion leading predominantly to mucosal and submucosal thickening, whereas a few lesions presented only with submucosal involvement. EUS detected suspicious lesions in two patients with negative endoscopy, which turn ed out to be KS on follow-up. Restaging after chemotherapy in three pa tients showed regression of lesions both on endoscopy and EUS. Conclus ions: EUS may contribute to better detection of early KS lesions and a more reliable delineation of the extent of gastrointestinal KS, which is valuable for assessing the effect of various forms of therapy.