Kaposi's sarcoma in patients with acquired immune deficiency syndrome. A flow cytometric DNA analysis of 26 lesions in 21 patients.

The DNA content of formalin-fixed, paraffin-embedded tissue from 21 patients (26 lesions) with Kaposi's sarcoma associated with acquired immune deficiency syndrome (AIDS) was analyzed by flow cytometry. The lesions were classified histologically into the following three types according to the predominant pattern: granulation tissue-like (two lesions), angioma/angiosarcoma-like (ten lesions), and spindle cell (14 lesions). All lesions showed exclusively DNA diploidy, and the S- phase fractions were usually low, ranging from 2% to 13% (mean, 6.9%). The follow-up periods were from 2 to 60 months. Five patients died, with one of the deaths attributed to pulmonary failure resulting from diffuse alveolar damage and Kaposi's sarcoma; the other deaths were attributed to infections. These results indicate that Kaposi's sarcoma is not a high-grade neoplasm and, combined with previously reported evidence, may suggest that Kaposi's sarcoma associated with AIDS is a proliferative process rather than a malignant neoplasm.