Kaposi's Sarcoma: An Unusual Presentation

Andrea C Young, MD, John M Mazzullo, MD, Amy R Simon, MD, Paul R Skolnik, MD

Disclosures

September 28, 2001

Case Report

A 56-year-old male with AIDS presented with a 20-pound weight loss over 3 weeks and a 2-month history of dyspnea and a debilitating dry cough. He was afebrile and his lungs were clear to auscultation. Mucocutaneous examination was normal. Room air arterial blood gas analysis and pulmonary function tests were normal. Chest radiograph was notable for slight increased reticularity in each mid-lung zone. High-resolution computed tomographic (CT) scanning of the chest was normal.

Despite minimal abnormalities on both physical examination and radiographic studies, the patient continued to have significant cough and dyspnea. He also complained of right lower quadrant pain; upper and lower endoscopy did not show any abnormalities. Bronchoscopy showed diffuse mucosal erythema and friability with discrete cherry-red lesions scattered throughout the tracheobronchial tree (Figure 1). Biopsy was not performed because of the concern for a significant risk of bleeding. BAL fluid was submitted for pathologic evaluation. Cytologic evaluation was negative for malignancy. Special stains, including methenamine silver stain and acid fast stain, were negative. Cultures yielded influenza A and Candida albicans. The patient was treated with paclitaxel and his respiratory symptoms significantly improved.

Bronchoscopic evaluation shows multiple discrete erythematous lesions throughout the tracheobronchial tree characteristic of Kaposi's sarcoma.

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