The first symptoms of Kaposi's sarcoma are usually red, purple, or brown patches, plaques, or nodules on the skin. (The abnormal growth of small blood vessels just below the skin gives the lesions their purplish hue.) They may look like bruises. In the classic, African, and immunosuppressive forms of the disease, the lesions usually grow slowly and develop over years. As the disease worsens, the legs may swell. In some cases, it will spread to other organs.
In the AIDS-related form, the cancer is much more aggressive, often growing to cover large areas and forming tumor-like masses. These lesions are usually soft and spongy at first, but they become hard and solid over time. The surface of the tumor may develop open ulcers that can become infected.
AIDS-related Kaposi's sarcoma is rarely confined to the skin. It often affects the mouth, lymph nodes, lungs, liver, spleen, and gastrointestinal tract. When the tumor involves the lungs, it often causes coughing, shortness of breath, and wheezing. The disease often progresses rapidly in the lungs. It may cause respiratory failure, which can be fatal.
When the disease involves the gastrointestinal tract, it rarely causes symptoms until it becomes very advanced. People may then develop symptoms of intestinal obstruction (nausea, vomiting, and abdominal pain) or bloody stools. If the lymph nodes become involved, severe swelling can occur, usually in the legs or face.
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