buy viagra 20 mg online , hemoptysis (coughing up blood), or chest pain, or as an incidental finding on chest x-ray. The diagnosis is usually confirmed by bronchoscopy when the lesions are directly seen, and often biopsied. Pathophysiology and diagnosis despite its name, it is generally not considered a true sarcoma, which is a tumor arising from mesenchymal tissue. Ks actually arises as a cancer of lymphatic endothelium and forms vascular channels that fill with blood cells, giving the tumor its characteristic bruise-like appearance. Kshv proteins are uniformly detected in ks cancer cells. Ks lesions contain tumor cells with a characteristic abnormal elongated shape, called spindle cells. The tumor is highly vascular, containing abnormally dense and irregular blood vessels, which leak red blood cells into the surrounding tissue and give the tumor its dark color. Inflammation around the tumor may produce swelling and pain. Although ks may be suspected from the appearance of lesions and the patient's risk factors, a definite diagnosis can only be made by biopsy and microscopic examination, which will show the presence of spindle cells. Detection of the kshv protein lana in tumor cells confirms the diagnosis. Treatment and prevention blood tests to detect antibodies against kshv have been developed and can be used to determine if a patient is at risk for transmitting infection to their sexual partner, or if an organ is infected prior to transplantation. Unfortunately, these tests are not available except as research tools and thus there is little screening for persons at risk for becoming infected with kshv, such as transplant patients. In europe and north america kshv is transmitted through saliva. Thus, kissing is a theoretical risk factor for transmission although transmisson between heterosexuals appears to be rare. viagra without a doctor prescription buy viagra online cheap viagra viagra without a doctor prescription viagra for sale buy viagra online cheap generic viagra generic viagra online buy viagra cheap viagra Higher rates of transmission among gay and bisexual men has be attributed to "deep kissing" [ another alternative theory suggests that use of saliva as a sexual lubricant might be a major mode for transmission. Prudent advice is to use commercial lubricants when needed and avoid deep kissing with partners who have kshv infection or have unknown status. Kshv is tr.