Iatrogenic Kaposi's sarcoma

Multiple sites of hypervascular tissue, which generally have the appearance of lymphoid tissue, is seen involving the posterior mediastinum, bilateral extrapleural spaces in the images chest, retroperitoneum, right subdiaphragmatic area, porta hepatis, pelvis, bilateral inguinal regions, bilateral subcutaneous fat of the medial thighs, along the course of the bilateral femoral vessels and popliteal vessels, the bilateral medial subcutaneous regions of the lower legs just distal to the knee joint level and the right medial foot subdermal tissues. There is associated extensive subcutaneous oedema of the lower legs. There are enlarged non-hypervascular retroperitoneal lymph nodes.

This process is most prominent in the bilateral inguinal region and the medial right lower leg subcutaneous tissue.

The affected tissues are heterogeneously enhancing with areas of central non-enhancement.

Bilateral native atrophic multicystic kidneys. Transplant kidney in the right iliac fossa appears normal.

Abdominal aorta is normal calibre. Coeliac artery is patent. The common hepatic artery gives rise to the left hepatic artery and the gastroduodenal artery while the right hepatic artery arises directly and separately from the coeliac artery. There is also an accessory left hepatic artery arising from the left gastric artery. The superior mesenteric artery, renal arteries and inferior mesenteric artery are patent. No popliteal artery aneurysms present.

There are multiple prominent and enlarged lymph nodes in the cervical chains bilaterally, and in the left retropharyngeal space, with moderate intense FDG avidity.

Extensive bilateral supraclavicular, internal mammary chain, mediastinal and bilateral hilar lymphadenopathy, with moderate intense FDG avidity. Multifocal areas of pleural thickening with intense FDG avidity suggesting possible further pleural nodal disease or pleural metastasis. Right para-aortic lymphadenopathy of the descending thoracic aorta noted.

Multiple prominent enlarged lymph nodes with moderate intense FDG avidity in keeping with nodal disease involving the right paracaval node, mesenteric nodes, along the right and left common iliac chain, right and left external iliac nodal chain, and bilateral inguinal femoral lymphadenopathy extending to the mid thigh level. Several prominent nodes are seen in the mesorectum, with mild moderate FDG avidity.

There is mucosal thickening of the descending colon and sigmoid colon, with mild moderate FDG avidity in keeping with colitis. Transplant kidney noted in the right iliac fossa.