Usefulness of molecular detection of human herpesvirus-8 in the diagnosis of Kaposi sarcoma by fine-needle aspiration

Kaposi sarcoma (KS), a multifocal angioproliferative disorder occurs most c ommonly in patients with AIDS, in whom it remains an important cause of mor bidity and mortality. KS is often in the differential diagnosis in HIV-infe cted patients undergoing fine-needle aspiration (FNA). FNA diagnosis of KS is usually made by morphologic observation of scant tissue fragments compos ed of bland spindle cells and crush artifact Human herpesvirus-8 (HHV-8) ha s been identified by polymerase chain reaction (PCR) amplification of DNA s amples isolated from various epidemiologic forms of KS. In apr attempt to i mprove the accuracy of KS diagnosis by FNA, we analyzed for the presence of HHV-8 DNA in 13 spindle-cell lesions evaluated by FNA: KS, 8 cases; granul omatous inflammation due to Mycobacterium avium-intracellulare, 1; nodular fasciitis, 1; dermatofibrosarcoma protuberans, 1; dermatofibroma, 1; benign spindle-cell lesion of nerve sheath origin, 1; and 2 lesions with lymphoid hyperplasia. DNA isolated from archival Wright-Giemsa-stained glass slides was used for the PCR amplification of the HHV-8 DNA sequences. All of the cases diagnosed as KS and I of the lymphoid hyperplasia cases were PCR-posi tive for HHV-8 DNA, while all other cases of spindle-cell lesions were nega tive. The molecular demonstration of HHV-8 DNA may be ct useful adjunct in the diagnosis of KS by FNA.