What are the signs and symptoms of pulmonary Kaposi sarcoma (KS)?

Answer

Usually, mucocutaneous lesions are the first clinical sign of KS. Lesions usually measure 1-2 cm in diameter and are raised, violaceous, and plaquelike. They may appear brown or black in patients with dark skin. Lesions increase in size and number as the disease progresses. Involvement of the GI tract, lymph nodes, lungs, and other viscera is common. Pulmonary involvement occurs in one third of patients and is recognized clinically in 10-15% of patients. Symptoms of KS, such as breathlessness, cough, fever, and wheezing, are nonspecific. Hemoptysis may occur but is unusual. Although lung involvement invariably follows mucocutaneous disease, this may not be clinically apparent.^[10]Pulmonary KS with bone metastases as the first presentation in HIV patients without the involvement of visceral organs or associated skin lesion has been reported.^[11]

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Media Gallery

Peribronchial thickening, nodularity, and septal lines in a patient with AIDS and pulmonary involvement of Kaposi sarcoma.
Marked peribronchovascular thickening on high-resolution CT in a patient with AIDS and pulmonary Kaposi sarcoma. Parenchymal nodularity and a unilateral pleural effusion are present.
Irregular thickening of interlobular septa resulting from tumor infiltration and ill-defined parenchymal micronodularity in a patient with AIDS and pulmonary Kaposi sarcoma.

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Author

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR Consultant Radiologist and Honorary Professor, North Manchester General Hospital Pennine Acute NHS Trust, UK

Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR is a member of the following medical societies: American Association for the Advancement of Science, American Institute of Ultrasound in Medicine, British Medical Association, Royal College of Physicians and Surgeons of the United States, British Society of Interventional Radiology, Royal College of Physicians, Royal College of Radiologists, Royal College of Surgeons of England

Disclosure: Nothing to disclose.

Coauthor(s)

Klaus L Irion, MD, PhD Consulting Staff, The Cardiothoracic Centre Liverpool NHS Trust, The Royal Liverpool University Hospital, UK

Klaus L Irion, MD, PhD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America

Disclosure: Nothing to disclose.

Sumaira Macdonald, MBChB, PhD, FRCP, FRCR, EBIR Chief Medical Officer, Silk Road Medical

Sumaira Macdonald, MBChB, PhD, FRCP, FRCR, EBIR is a member of the following medical societies: British Medical Association, British Society of Interventional Radiology, British Society of Endovascular Therapy, Cardiovascular and Interventional Radiological Society of Europe, International Society for Vascular Surgery, Royal College of Physicians, Royal College of Radiologists, Scottish Radiological Society, Vascular Society of Great Britain and Ireland

Disclosure: Nothing to disclose.

Carolyn M Allen, MBChB, MRCP, FRCR Consultant Radiologist, Clinical Director, Department of Clinical Radiology, North Manchester General Hospital, UK

Carolyn M Allen, MBChB, MRCP, FRCR is a member of the following medical societies: Society of Thoracic Radiology

Disclosure: Nothing to disclose.

Specialty Editor Board

Bernard D Coombs, MB, ChB, PhD Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand

Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD Attending Radiologist, Teaching Coordinator for Cardiac Imaging, Radiology Residency Program, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine

Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, Society of Nuclear Medicine and Molecular Imaging

Disclosure: Nothing to disclose.

Additional Contributors

Satinder P Singh, MD, FCCP Professor of Radiology and Medicine, Chief of Cardiopulmonary Radiology, Director of Cardiac CT, Director of Combined Cardiopulmonary and Abdominal Radiology, Department of Radiology, University of Alabama at Birmingham School of Medicine

Disclosure: Nothing to disclose.

Acknowledgements

Alberto Alonso, MD, MRCP Specialist Registrar in Radiology, Department of Radiology, Manchester Royal Infirmary, UK

Alberto Alonso, MD, MRCP is a member of the following medical societies: Radiological Society of North America, Royal College of Physicians, and Royal College of Radiologists

Disclosure: Nothing to disclose.

What are the signs and symptoms of pulmonary Kaposi sarcoma (KS)?

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