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