August 11, 2011

Kaposi's Sarcoma

Axial CT image shows perihilar peribronchovascular thickening (arrows) and several small ill-defined nodules in the peribronchovascular distribution.
Axial CT image shows patchy groundglass opacities and consolidation in the right middle and lower lobes.

  • Multicentric neoplasm occuring in three distinct clinical settings: classic (middle-aged adults or elderly men with indolent course), endemic (native populations of equatorial Africans) and disseminated forms (AIDS and immunosuppressed recipients of organ transplants)
  • Associated with human herpesvirus type 8
  • Cutaneous manifestations usually precede visceral disease
  • Respiratory disease is a late manifestation of the disease, it can involve trachea, bronchial tree, pleura and lung parenchyma
  • Diagnosis of respiratory disease is often made presumptively based on clinical/imaging appearance and exclusion of other entities. Biopsy is most definitive.
  • Treatment of pulmonary disease almost always involves chemotherapy
Thoracic Imaging Findings
  • Two patterns: interstitial and nodular
  • Interstitial pattern -- septal lines, localized/focal consolidations, perihilar distribution, "flame-shaped" opacities
  • Nodular pattern -- ill-defined nodules of various sizes that may coalesce into areas of patchy consolidation
  • Up to 60% has pleural effusion
  • Up to 16% has hilar/mediastinal lymphadenopathy
Our case: Kaposi's sarcoma, biopsy-proven

Humes HD. Kelley's Essentials of Internal Medicine, 2001.
Parsons PE, Heffner JE. Pulmonary/reespiratory Therapy Secrets, 2002.

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