Chest
Volume 108, Issue 6, December 1995, Pages 1622-1626
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Clinical Investigations: Imaging
Intrathoracic Kaposi's Sarcoma: CT Findings

https://doi.org/10.1378/chest.108.6.1622Get rights and content

Aim

To describe the thin CT scans findings in AIDS patients with intrathoracic Kaposi's sarcoma (KS).

Material and methods

Fifty-three CT scans of patients with KS were retrospectively reviewed. The diagnosis of intrathoracic KS was established histologically (n=17) or on the association of skin KS and the visualization of characteristic endobronchial lesions (n=36). CT scans were performed with thin slices (2 mm) obtained at 10-mm intervals, and a 512×512 reconstruction matrix. No patients had Pneumocystis carinii pneumonia within the 3 months preceding the CT scan examination.

Results

Numerous nodules (n=42), tumoral masses (n=28), bronchovascular pathways thickening (n=35), and pleural effusions (n=28) were the most frequent patterns. Septal lines (n=15), ground-glass opacities (n=3), and mediastinal adenopathies (n=8) were not frequent.

Conclusion

Numerous nodules, tumoral masses, bronchovascular pathways thickening, and bilateral pleural effusions were the main signs of intrathoracic KS; their association (66%) is very characteristic. An opportunistic infection or mycobacteriosis must be sought if the thin CT scans reveal ground-glass opacities and/or mediastinal adenopathies.

Section snippets

MATERIALS AND Methods

CT scans were obtained in 53 patients with the diagnosis of intrathoracic KS. Patients ranged in age from 21 to 60 years (mean, 39 years). There were 52 men and 1 woman. There were 48 homosexual men and 4 heterosexual men (2 Africans, 1 Haitian, and 1 man infected by blood transfusion) and 1 woman (prostitute). Nine patients were excluded because of Pneumocystis carinii pneumonia association.

The initial diagnosis of KS was established by histologic study in 23 patients: 20 by skin or mucosa

Results

Four signs dominate CT features.

  • 1.

    Nodules were present in 42 patients (79%). They were micronodules in 22 cases (52%), macronodules (Fig 1) in 12 cases (29%), and the association of both sizes in 8 cases (19%). Nodules were disseminated and their number was superior to 10 in 31 cases (71%); spiculation of the margins was present in 30 cases (71%). Nodules were located around bronchi in only three cases.

  • 2.

    Bronchovascular pathways thickening (Fig 2) was present in 35 cases (66%); the diagnosis

Discussion

KS develops in about 35% of patients with AIDS,10, 11, 12 primarily the subgroup of homosexual men.3,13 Usually they have an aggressive form of the disease, with about half having involvement of visceral organs.

A wide spectrum of chest radiographic manifestations of intrathoracic KS has been described.14, 15, 16, 17, 18, 19, 20, 21 Significant variation in the frequency and type of pulmonary infiltrates, as well as nodules, adenopathies, and pleural disease, have been reported. Many of these

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