Chest
Clinical Investigations: ImagingIntrathoracic Kaposi's Sarcoma: CT Findings
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
References (32)
- et al.
Systemic treatment of AIDS-related Kaposi's sarcoma: results of a randomized trial
Am J Med
(1991) - et al.
Radiographic manifestations of pulmonary disease in the acquired immunodeficiency syndrome (AIDS)
Semin Roentgenol
(1987) - et al.
Kaposi's sarcoma: CTradiographic correlation
Chest
(1989) - et al.
Kaposi's sarcoma and acquired immunodeficiency syndrome: post mortem findings in 24 cases
J Am Acad Dermatol
(1987) - et al.
Pulmonary complications of the acquired immunodeficiency syndrome: a clinicopathologic study of 70 cases
Hum Pathol
(1985) - et al.
Pulmonary manifestations of Kaposi's sarcoma
Chest
(1987) - et al.
Pulmonary Kaposi's sarcoma in the acquired immune deficiency syndrome: clinical, radiographic, and pathologic manifestations
Am J Med
(1986) - et al.
Bronchoscopic and radiologic features of Kaposi's sarcoma involving the respiratory system
Chest
(1986) - et al.
Spectrum of pulmonary diseases associated with the acquired immune deficiency syndrome
Am J Med
(1985) - et al.
Kaposi's sarcoma presenting as pulmonary disease in the acquired immunodeficiency syndrome: diagnosis by lung biopsy
Hum Pathol
(1984)
Bilateral chylothorax with pulmonary Kaposi's sarcoma
Chest
Indications for and diagnostic efficacy of open-lung biopsy in the patient with acquired immunodeficiency syndrome (AIDS)
Ann Thorac Surg
Noninfectious pulmonary complications of infection with the human immune deficiency virus
Am Rev Respir Dis
Pulmonary complications of the acquired immunodeficiency syndrome: an update
Am Rev Respir Dis
Kaposi's sarcoma causing pulmonary infiltrates and respiratory failure in the acquired immunodeficiency syndrome
Ann Intern Med
Thoracic Kaposi sarcoma in AIDS: CT findings
J Comput Assist Tomogr
Cited by (60)
Approach to Peribronchovascular Disease on CT
2019, Seminars in Ultrasound, CT and MRIThoracic Neoplasms in Children: Contemporary Perspectives and Imaging Assessment
2017, Radiologic Clinics of North AmericaCitation Excerpt :Although the imaging feature of KS can resemble pulmonary infection, in a patient with known mucocutaneous KS and abnormal chest radiographs, pulmonary involvement should be suspected.43 CT is the imaging modality of choice and an accurate diagnosis is made based on the CT findings in approximately 90% of cases.44 CT findings mirror the radiographic findings with bronchial wall thickening, septal thickening, hilar lymphadenopathy, and ill-defined nodules in a perihilar distribution (Fig. 2B).43
Pulmonary manifestations in HIV-infected patients: A diagnostic approach
2014, Revue des Maladies RespiratoiresNoninfectious pulmonary complications of human immunodeficiency virus infection
2014, American Journal of the Medical SciencesKaposi's sarcoma: Imaging overview
2011, Seminars in Ultrasound, CT and MRICitation Excerpt :Lung mass (27%-53%), ground-glass opacities (23%), and cavitation (8%) are less frequent (Figs. 8 and 9). CT findings allow the diagnosis of pulmonary KS to be confidently made in most cases.24,25 Bilateral abnormal hilar densities extending into the adjacent pulmonary parenchyma are characteristic, and hilar lymphadenopathy is more common than enlarged mediastinal lymph nodes26 (Fig. 10).
Fatal disseminated classic Kaposi sarcoma involving the lungs in an HIV negative patient: An exceptional presentation of the disease
2010, Respiratory Medicine CMECitation Excerpt :Like our patient, some patients had pericardial effusion, associated or not with pleural effusion. These main CT scan findings were associated in 66%.17 The author found that the association of these findings is very characteristic.