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Kaposi's sarcoma

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis almost certain

Presentation

HIV-positive patient with the presentation of purple dermal patches and plaques.

Patient Data

Age: 30 years
Gender: Male
x-ray

There are reticular nodular opacities predominantly in the central lung of the mid and lower zones. There is some confluence especially right mid and lower zone. There are bibasal effusions, left greater than right. Paratracheal and hilar lymph nodes are suspected.

Case Discussion

Typical features of pulmonary Kaposi's sarcoma. A wide differential diagnosis exists including and especially PJP and other atypical infections. Mycobacterium tuberculosis, lymphoma and fungal infections need to be excluded prior to confirming imaging features are consistent with Kaposi's sarcoma. Often in an HIV setting multiple infections and AIDS-related lymphoma are all present simultaneously and imaging likely represents a combination of pathologies. In this instance PJP, active pulmonary tuberculosis and lymphoma were all excluded with further workup.

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