대한흉부영상의학회 Weekly Chest Cases

Case No : 130 Date 2000-04-22

Courtesy of Jin Mo Goo, MD, Jung-Gi Im, MD. / Seoul National University Hospital, Seoul, Korea
Age/Sex 41 / M
Chief ComplaintCough and dyspnea for six months. He was known to be HIV-positive and a CD4 level was 4 cells/ mm3. He had small, raised reddish-purple nodules on the skin.

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Diagnosis With Brief Discussion

Diagnosis: Kaposis sarcoma (autopsy-proven)
Radiologic Findings: Chest radiograph shows nodular and linear infiltrates with a perihilar and basal distribution. There are bilateral small pleural effusions.
HRCT scan shows bilateral nodular or flame-shaped lesions along bronchovascular bundles. CT scan viewed at mediastinal windows shows bilateral pleural effusions and enlargement of subcarinal lymph node.
Brief Review: Kaposis sarcoma is the most common malignancy in AIDS patients, and cutaneous Kaposis sarcoma is frequently the initial manifestation of the disease. Disseminated Kaposis sarcoma may involve any organ system, including the lung, but the gastrointestinal tract and lymph nodes are the most frequently affected. The presence of cutaneous Kaposis sarcoma is an important pointer to the possibility of pulmonary involvement. It appears that pulmonary Kaposis sarcoma is rare in the absence of cutaneous involvement. Another clinical pointer is the occurrence of hemoptysis.
There is a tendency to perihilar predominance, reflecting a bronchocentric distribution of the lesion (1). The pulmonary infiltrates of Kaposis sarcoma are not subject to significant day-to-day fluctuations in severity as may be the case with pulmonary edema or the pulmonary opportunistic infections. Pleural involvement by Kaposis sarcoma is common. Effusions are most often bilateral and may be large. On CT, pulmonary parenchymal disease is characterized by multiple, bilateral flame-shaped or nodular lesions with ill-defined margins distributed along bronchovascular bundles (2).
References: 1. Sivit CJ, Schwartz AM, Rockoff SD. Kaposis sarcoma of the lungs in AIDS: radiologic-pathologic analysis. AJR 1987;148:25-28.
2. Wolff SD, Kuhlman JE, Fishman EK. Thoracic Kaposi sarcoma in AIDS: CT findings. J Comput Assist Tomogr 1993;17:60-62.
Keywords: Lung, Malignant tumor,

No. of Applicants : 45

▶ Correct Answer : 35/45, 77.8%

- 媛理
- 媛怨
- 寃쎈 議곗
- 寃쎈 沅
- 寃쎈
- 寃쎈
- 怨
- 怨
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- 留臾멸린
- 遺理湲곕났
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- 源
- 諛李쎈
- 理
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- 源
- 源誘쇱
- 以
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- 源
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- 源
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- 沅諛곗＜
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- Asan Medical Center Jeong Hyun Lee
- Gachon Medical School Gil Medical Center Seo Joon Beom
- Hospital General Universitario de Alicante, Spain Juan Arenas
- Matsuyama Red Cross Hospital, Matsuyama, Japan Shunya Sunami
- Samsung Medical Center Kyung Soo Lee
- Seoul National University Hospital Seong Ho Park
- Stedelijk OLV Ziekenhuis Mechelen, Belgium Ivan Pilate

대한흉부영상의학회 Korean Society of Thoracic Radiology

Archive of Old Cases

Case No : 130 Date 2000-04-22

Discussion

No. of Applicants : 45