背景与目的:肾移植者所发生的卡波西肉瘤是由长期免疫抑制性治疗所引起,而确切的肿瘤发生过程至今尚未阐明。病理组织研究发现此类肉瘤与其他几种类型并无区别。新疆的地方性卡波西肉瘤较为常见,尤其是维族人群,可能是中国患病率最高的。为了解其可能的病因发病学机制以及与其他类型卡波西肉瘤的关系,我们对3例肾移植后卡波西肉瘤进行组织病理学与免疫组化研究。方法:取自本院3例(2例维吾尔族及1例汉族患者)肾移植相关型卡波西肉瘤标本,经存档蜡块切片分别行HE染色与CD34、第Ⅷ因子、V im entin、Actin(平滑肌)及纤连蛋白(FN)的S-P法免疫组织化学染色检测。结果:所有标本的组织切片其病理组织学结构和细胞特点与典型的卡波西肉瘤无明显不同。其早期病变非常局限,只有少数不规则扩张的血管裂隙和聚集肥胖(上皮样)细胞;中期,病变范围变宽,并出现梭形细胞增生,呈束状,编织状,血管受压,管腔呈裂隙状,但病灶周边的增生血管仍扩张充血;晚期,增生的梭形细胞异型性明显,核分裂象增多。免疫组化:肿瘤细胞CD34,血管内皮细胞第Ⅷ因子有较强阳性染色反应,而V im entin阳性较弱,Actin(平滑肌)与FN呈阴性反应。结论:肾移植相关型卡波西肉瘤的病理组织学与免疫组化特性与其他类型的卡波西肉瘤并无明显本质性差别,可能反映了这类病变具有相似的病因发病学变化。而明显的种族与地域患病率不同,说明基因背景在卡波西肉瘤的发生发展过程中可能起关键性作用。 BACKGROUND & OBJECTIVE: Kaposi’s sarcoma developed in renal transplant recipients is caused by long-term immunosuppressive therapy and the exact course of the tumorigenesis has not been elucidated so far. Pathological studies have found that these sarcomas do not differ from the other types. The endemic Kaposi’s sarcoma in Xinjiang is more common, especially for the Uighur population, probably the highest in China. To understand its possible etiology and pathogenesis and the relationship with other types of Kaposi’s sarcoma, we performed histopathological and immunohistochemical studies of 3 Kaposi’s sarcomas after kidney transplantation. Methods: Three specimens of Kaposi’s sarcoma, which were related to renal transplantation in our hospital, were collected from 3 cases (2 Uighur and 1 Han nationality). HE staining and CD34, factor Ⅷ, Vimin, Actin (Smooth muscle) and fibronectin (FN) SP immunohistochemical staining. RESULTS: Tissue sections of all specimens showed no significant differences in histopathology and cell characteristics from the typical Kaposi’s sarcoma. The early lesions are very limited, only a few irregular expansion of vascular fissures and accumulation of obesity (epithelial) cells; metaphase, the lesion widens, and spindle cell proliferation, showed a bundle, braided, vascular compression, lumen Showing a fissure, but the lesions around the proliferative blood vessels still dilate congestion; late, hyperplasia of spindle cells atypia, increased mitosis. Immunohistochemistry: CD34 of tumor cells and factor Ⅷ of vascular endothelial cells had a strong positive staining reaction, while Vim entin positivity was weak, Actin (smooth muscle) and FN negative reaction. Conclusion: The pathological and immunohistochemical characteristics of renal transplantation-related Kaposi’s sarcoma are not significantly different from other types of Kaposi’s sarcoma, which may reflect the similar etiology and pathogenesis of these lesions. The obvious racial and geographical prevalence rates are different, indicating that the genetic background in the occurrence and development of Kaposi’s sarcoma may play a key role.