Season 8 Case 32

History: cough, shortness of breath, fever

Season 8 Case 32

History: cough, shortness of breath, fever 

Answer: Kaposi’s Sarcoma

KS is a low-mid grade mesenchymal tumor that involves blood/lymphatic vessels of the skin, lymph nodes, lungs, GI tract, etc. Not considered a true “sarcoma”. Believed related to human herpes virus type 8 (HHV8)

Comes in 4 variants:

Classic - generally limited to lower limb w/ purple dermal plaques

Iatrogenic - related to immunosuppression during organ transplantation

AIDS-related - HIV+ patients with CD4 <200 (considered an AIDS defining illness)

Endemic - men in equatorial Africa

Imaging: 

XR – linear interstitial nodules vs fluffy ill-defined nodules often in a peri-hilar to mid/lower lung predominance.  +pleural effusion + adenopathy

CT - flame shaped nodular opacities in a symmetric/perihilar distribution often with surrounding glass-glass appearance +adneopathy (?high attentuation)

Nucs - can be helpful to differentiate from lymphoma

Th-201 is positive in both KS and lymphoma

Ga67 usually negative in KS but positive in lymphoma/infection