Pulmonary Kaposi Sarcoma: A Case Report and Review of the Literature

Case Series

Austin J HIV/ AIDS Res. 2016; 3(1): 1019.

Pulmonary Kaposi Sarcoma: A Case Report and Review of the Literature

Egwuonwu SO*

Department of Internal Medicine, Southwestern Medical Center, Lawton, Oklahoma

*Corresponding author: Egwuonwu SO, Department of Internal Medicine, Southwestern Medical Center. Lawton. Oklahoma

Received: January 04, 2016; Accepted: January 22, 2016; Published: January 25, 2016


Kaposi sarcoma is the most common neoplasm associated with Human Immunodeficiency Virus (HIV) infection. It commonly affects the skin and visceral organs. The commonest organs affected are the lungs and gastrointestinal tract. A 40 year old HIV positive homosexual male presented with fever, intractable cough and dyspnea. He was noted with non blanching purple skin lesions all over his body. CD4 count was 63 cells/mm3and viral load of 50,000. Computed Tomography revealed multiple opacities and pulmonary nodules. Biopsy of the skin lesion confirmed Kaposi sarcoma. Bronchoscopy revealed multiple endobronchial KS lesions. Biopsy of endobronchial lesion confirmed pulmonary KS. He was initiated on highly active antiretroviral therapy (HAART). Chemotherapy was subsequently added. He responded well to treatment.

Pulmonary Kaposi sarcoma can occur with or without cutaneous Kaposi sarcoma lesions. HAART is the mainstay of treatment.

Keywords: Pulmonary Kaposi sarcoma; Human immunodeficiency virus; Highly active antiretroviral therapy; Bronchoscopy


KS: Kaposi Sarcoma; HIV: Human Immunodeficiency Virus; CT: Computed Tomography; HAART: Highly Active Antiretroviral Therapy; HHV 8: Human Herpes Virus 8; BAL: Bronchoalveolar Lavage; CD4: Cluster of Differentiation 4.


Kaposi sarcoma is the commonest neoplasm associated with Human Immunodeficiency Virus (HIV) Infection. In the United States, its prevalence has declined since the advent of Highly Active Antiretroviral Therapy (HAART). The clinical course of HIVRelated Kaposi sarcoma could be indolent with minor cutaneous or lymph node disease or aggressive with extensive skin and visceral involvement. The lungs and gastrointestinal tract are the commonest systems affected. This article describes pulmonary Kaposi sarcoma with a review of clinical features, diagnosis and treatment.

Case Presentation

A 40 year-old HIV positive homosexual male not on HAART Therapy presents with a 1month history of intractable cough, hemoptysis and shortness of breath. He had associated night sweats, 5 month history of generalized skin lesions and 30 pound weight loss over 1 year. Physical examination revealed a non blanching purple skin lesion on the face, arms, legs and soles of both feet. Examination of the oral mucosa revealed thrush in the soft and hard palate and dark purple lesions in the posterior pharynx. Breath sounds were decreased bilaterally. Cardiovascular and abdominal exam were unremarkable. White blood cell and platelet counts were within normal limits. He was anemic with hemoglobin of 10 g/dl (14 – 17g/dl). Viral load was 50,000 and CD4 Count was very low at 63 cells/mm3 (500 – 1500 cells/mm3). Chest x-ray showed multiple nodular opacities in both lung fields. Computed tomography of the chest revealed multiple diffuse opacities and pulmonary nodules (Figure 1). Skin biopsy confirmed the cutaneous lesions to be Kaposi sarcoma. Bronchoscopy revealed purple plaques throughout most of his airways. Endobronchial biopsy confirmed Kaposi sarcoma. Given his clinical history, laboratory studies, radiologic imaging and bronchoscopy findings and biopsy result, he was diagnosed with extensive cutaneous and pulmonary Kaposi sarcoma. He was started on HAART therapy with subsequent addition of 8 cycles of liposomal doxorubicin. He responded well to treatment and still alive and well 2 years after diagnosis.

Citation: Egwuonwu SO. Pulmonary Kaposi Sarcoma: A Case Report and Review of the Literature. Austin J HIV/ AIDS Res. 2016; 3(1): 1019. ISSN : 2380-0755