Which CT findings are characteristic of pulmonary Kaposi sarcoma (KS)?

Updated: Mar 13, 2019
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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In patients with pulmonary KS, characteristic CT findings correlate with findings on chest radiography, with bronchial wall thickening, ill-defined nodules, and areas of consolidation in a perihilar bronchocentric distribution appearing on CT scans (see the images below). Among AIDS-related thoracic diseases, KS is one of the most reliable diagnoses made on the basis of imaging findings. An accurate diagnosis of pulmonary KS can be established by CT scans in 90% of patients. [9, 12, 13, 14]

Marked peribronchovascular thickening on high-reso 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 resulti Irregular thickening of interlobular septa resulting from tumor infiltration and ill-defined parenchymal micronodularity in a patient with AIDS and pulmonary Kaposi sarcoma.

Frequently, the nodules are seen to be surrounded by a halo of ground-glass attenuation, representing localized hemorrhage. Interlobular septal thickening is a common feature seen on high-resolution CT (HRCT).

Pleural effusions and, less commonly, adenopathy may be identified.

Occasionally, patients with pulmonary KS with hemoptysis may present with patchy ground-glass attenuation caused by hemorrhage.

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