Pulmonary Kaposi's Sarcoma - Initial Presentation of HIV Infection

Kaposi’s sarcoma is the most common malignancy associated with human immunodeficiency virus. It commonly affects the skin but can present with visceral involvement, including the lungs. A 23-year-old homosexual male presented with fever, intractable cough and dyspnea. On examination, multiple skin lesions were revealed. Chest computed tomography visualized multiple nodules, bronchoscopy showed endobronchial lesions. Histopathological study of the skin lesions showed Kaposi’s sarcoma and the endobronchial biopsy – a proliferative inflammatory process. Diagnosis of Kaposi’s sarcoma was made based on clinical, laboratory, computed tomography and bronchoscopy data as well as on the regression of pulmonary nodules by the combination antiretroviral therapy. The diagnosis of pulmonary Kaposi’s sarcoma is still a challenge due to concomitant occurrence of opportunistic infections. This case emphasizes the need to strongly consider pulmonary KS as a possible cause for respiratory illness in any HIV-positive patient with cutaneous Kaposi’s sarcoma.