Kaposi sarcoma (KS) is an intermediate vascular sarcoma that can cause significant morbidity and mortality in patients if left untreated. It is associated with human herpes virus 8 (HHV-8) infection. Definitive diagnosis is supported by classic histology including slit-like vascular spaces, spindle cells, lymphocyte infiltration, and extravasated RBCs on hematoxylin and eosin (H&E) stain and positive immunohistochemical (IHC) staining for HHV-8. We present a challenge we encountered in detecting HHV-8 by IHC in a mucosal lesion demonstrating classic histology for KS.

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