From Effusion to Conclusion: Diagnosis of Intrathoracic Kaposi Sarcoma With Video-Assisted Thoracoscopic Surgery

Kaposi sarcoma (KS) is an angioproliferative neoplasm driven by human herpesvirus-8 that primarily affects immunocompromised patients, particularly patients with advanced HIV infection or AIDS. Pulmonary and pleural involvement is uncommon and may mimic other infections or malignant diseases. We report a 49-year-old man with AIDS and recurrent pleural effusions in whom repeated thoracenteses were nondiagnostic. Diagnosis was ultimately achieved through video-assisted thoracoscopic surgery, revealing intrapleural lesions consistent with KS on human herpesvirus-8 immunostaining. This case emphasizes the importance of maintaining suspicion for KS in immunocompromised patients with unexplained effusions and underscores the dual diagnostic and therapeutic value of video-assisted thoracoscopic surgery.