Pulmonary Kaposi's Sarcoma - Initial Presentation of HIV Infection 

Abstract

Kaposi's sarcoma is the most common malignancy associated with human immunodeficiency virus. It commonly affects the skin but can present with visceral involvement, including the lungs. A 23-year-old homosexual male presented with fever, intractable cough and dyspnea. On examination, multiple skin lesions were revealed. Chest computed tomography visualized multiple nodules, bronchoscopy showed endobronchial lesions. Histopathological study of the skin lesions showed Kaposi's sarcoma and the endobronchial biopsy -a proliferative inflammatory process. Diagnosis of Kaposi's sarcoma was made based on clinical, laboratory, computed tomography and bronchoscopy data as well as on the regression of pulmonary nodules by the combination antiretroviral therapy. The diagnosis of pulmonary Kaposi's sarcoma is still a challenge due to concomitant occurrence of opportunistic infections. This case emphasizes the need to strongly consider pulmonary KS as a possible cause for respiratory illness in any HIV-positive patient with cutaneous Kaposi's sarcoma.

Pulmonary Kaposi Sarcoma without Respiratory Symptoms and Skin Lesions in an HIV-Naïve Patient: A Case Report and Literature Review

“…It is uncommon in women while it occurs in approximately 90% to 95% of homosexual and bisexual men [45]. In some cases, pKS is the initial presentation of HIV infection, with clinical features suggesting pulmonary involvement that are challenging to distinguish from opportunistic pneumoniae [46][47][48]. In some other cases, the simultaneous occurrence of KS and other diseases has been observed, from the most frequently related Castleman syndrome to less frequent comorbidities, such as psoriasis [49,50].…”

CE: HIV-Associated Kaposi Sarcoma in the Combination Antiretroviral Therapy Era

“…Patients with GI Kaposi sarcoma may present with nonspecific symptoms such as weight loss, abdominal pain, dyspepsia, diarrhea, nausea, vomiting, and GI bleeding, but some may be asymptomatic 44, 45. Pulmonary Kaposi sarcoma may cause cough, dyspnea, and coarse rales on auscultation 46, 47. Hemorrhagic or chylous (milky or chalky) pleural effusions as well as diffuse alveolar hemorrhage have also been associated with pulmonary Kaposi sarcoma 48.…”

“…44,45 Pulmonary Kaposi sarcoma may cause cough, dyspnea, and coarse rales on auscultation. 46,47 Hemorrhagic or chylous (milky or chalky) pleural effusions as well as diffuse alveolar hemorrhage have also been associated with pulmonary Kaposi sarcoma. 48 However, there have been cases of PLWH who have Kaposi sarcoma without known pulmonary Kaposi sarcoma but with chylous pleural effusions.…”