대한흉부영상의학회 Korean Society of Thoracic Radiology

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Weekly Chest CasesCases by Disease Category

Case No : 1305 Date 2022-10-24

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  • Courtesy of Min Kyung Jung, Jeong Min Ko, Hyun Jin Park / Department of Radiology, College of Medicine, St. Vincent
  • Age/Sex 52 / M
  • Chief ComplaintDyspnea for 2 weeks HIV positive
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4
  • Figure 5

Diagnosis With Brief Discussion

Diagnosis
acquired immunodeficiency syndrome (AIDS)
Radiologic Findings
Fig 1. Chest radiograph shows bilateral ill-defined nodular and linear infiltrates with a perihilar and basal distribution. There are bilateral small pleural effusions.

Fig 2. Lung window setting of the chest CT scan shows peribronchovascular and interlobular septal thickening with nodularity in both lower lobes. Small nodular opacities with bilateral and symmetrical perilymphatic and peribronchovascular distribution in both lower lobes.

Fig 3 and 4. Contrast-enhanced mediastinal window setting of chest CT scan shows irregular bronchial wall thickening and enhacement along the both main bronchi. There are peribronchovascular and interlobular septal thickening with enhancement and nodularity in B lungs, especially B lower lobes. There are small enhancing lymph nodes in bilateral mediastinum. There are bilateral small pleural effusions.

Fig 5. Bronchoscopy shows red macular lesions in the distal trachea.


He underwent bronchoscopic biopsy and pathologic result was spindle cell proliferation with vascular space in submucosal layer, consistent with Kaposi sarcoma. Human herpes virus type 8 was positive.

Contrast-enhanced mediastinal window setting of chest CT scan shows multiple small hypodense peripheral portal nodules in liver.
Duodenoscopy shows nodular red to purple involvement of stomach.
Brief Review
Kaposi sarcoma (KS) is a low-grade vascular tumor that typically manifests as one of four variants: classic KS, endemic (African) KS, iatrogenic (organ transplant
References
RadioGraphics 2006; 26:1169
Keywords

No. of Applicants : 87

▶ Correct Answer : 50/87,  57.5%
  • - , Japan KYOKO NAGAI
  • - Showa General Hospital , Japan MASAFUMI KAIUME
  • - Shiga University of Medical Science , Japan AKITOSHI INOUE
  • - Hpital du Sacr Coeur , Canada Andrea Ojanguren
  • - McGill University Health Center , Canada ALEXANDRE SEMIONOV
  • - CHCB , France LE GUEN RAPHAEL
  • - NIMS, HYDERABAD , India BHASKAR K
  • - National Center of Neurology and Psychiatry , Japan MOTO NAKAYA
  • - , Italy PAOLO BALDASSARI
  • - Chungbuk National University Hospital , Korea (South) JIYUN KANG
  • - Vita Hospital , Brazil DIOGO LAGO PINHEIRO
  • - Other , Korea (South) SEONGSU KANG
  • - , Korea (South) JIN YOUNG LEE
  • - Oita University, Faculty of Medicine , Japan FUMITO OKADA
  • - Seoul Medical Center , Korea (South) HYUK GI HONG
  • - Osaka University , Japan AKINORI HATA
  • - , Japan HIKARI FUKUI
  • - Ajou University Hospital , Korea (South) HAEIN LEE
  • - Osaka Metropolitan University , Japan HIROTAKA TAKITA
  • - Shimada General Medical Center , Japan HAYATO NOZAWA
  • - Ajou University Hospital , Korea (South) HYUNSEUNG LEE
  • - The University of Tokyo Hospital , Japan TOSHIHIRO FURUTA
  • - Ajou University Hospital , Korea (South) MINJI KIM
  • - , India JAHNAVI GADUPTI
  • - Gifu University Hospital , Japan Yo Kaneko
  • - , Japan KENTARO KOTANI
  • - Kyoto University Hospital , Japan YASUHISA KURATA
  • - Ajou University Hospital , Korea (South) YOU NA KIM
  • - Osaka Metropolitan University Hospital , Japan SHU MATSUSHITA
  • - Jichi Medical University, School of Medicine , Japan MITSURU MATSUKI
  • - University of Tsukuba, Dept of Radiology , Japan MANABU MINAMI
  • - Eskisehir Sehir Hastanesi , Turkey MURAT SAHIN
  • - Osaka metropolitan university Hospital , Japan TATSUSHI OURA
  • - Chonnam National University Hwasun Hospital , Korea (South) JEONG YEOP LEE
  • - Manipal hospital Hebbal ,Bengaluru , India PRAVIN KUMAR M
  • - Ulsan University Hospital , Korea (South) SUNGMIN KIM
  • - Other , Korea (South) KYU-CHONG LEE
  • - , Japan KENSUKE DOMAE
  • - Paras hospital, Panchkula , India SHALEEN RANA
  • - Nishida Hospital , Japan SHOJI OKUDA
  • - Seoul National University Bundang Hospital , Korea (South) YOONAH DO
  • - Chonbuk National University Hospital , Korea (South) MINJEE KIM
  • - Pusan National University Yangsan Hospital , Korea (South) JI HWAN KIM
  • - Toranomon Hospital , Japan KAORU SUMIDA
  • - Ichinomiya Nishi Hospital , Japan Takao Kiguchi
  • - , Japan YUMI MAEHARA
  • - , Japan YUKI HAYASHI
  • - , Korea (South) HM PARK
  • - the first affiliatited hospital of nanjing medical univercity , China HAI XU
  • - Jiangsu province hospital , China WANGJIAN ZHA
▶ Correct Answer as Differential Diagnosis : 15/87,  17.2%
  • - Saitama-Sekishinkai Hosptal , Japan MIHOKO YAMAZAKI
  • - Jichi Medical University Hospital , Japan JUN KANZAWA
  • - Affilitated Hospital of Jining Medical college , China JIANG SHENG HUA
  • - Chonnam National University Hwasun Hospital , Korea (South) SEONGWOO CHO
  • - Tiger Gate Hospital , Japan SHIN-ICHI CHO
  • - Soonchunhyang University Hospital Bucheon , Korea (South) HYEJOO PARK
  • - , Japan YUKIKO USUI
  • - Inje University Pusan Paik Hospital , Korea (South) JIYEON HAN
  • - Chungbuk National University Hospital , Korea (South) MIHYEON PARK
  • - , Qatar NABIL SHERIF MAHMOOD
  • - Dokkyo Medical University , Japan HIROAKI ARAKAWA
  • - Kyoto University Hospital , Japan SATOSHI IKEDA
  • - Yonsei University,Severance Hospital , Korea (South) SEO BUM CHO
  • - Chonnam Hospital , Korea (South) JAEHYUN PARK
  • - Hanyang University Hospital , Korea (South) SEUNG JIN YOO
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