Intrathoracic Kaposi's sarcoma. CT findings

Area of Science:

• Radiology
• Oncology
• Infectious Diseases

Background:

• AIDS patients are susceptible to opportunistic infections and malignancies.
• Intrathoracic Kaposi's sarcoma (KS) is a significant complication in advanced HIV.
• Accurate imaging is crucial for diagnosing and managing intrathoracic KS.

Purpose of the Study:

• To detail the thin-section CT scan features of intrathoracic Kaposi's sarcoma (KS) in patients with Acquired Immunodeficiency Syndrome (AIDS).
• To establish imaging criteria for differentiating KS from other pulmonary conditions in this patient group.

Main Methods:

• Retrospective review of 53 thin-section (2 mm) CT scans from patients with confirmed intrathoracic KS.
• Diagnosis confirmation through histology or combined skin KS and characteristic endobronchial lesions.
• Exclusion of patients with recent Pneumocystis carinii pneumonia.

Main Results:

• Frequent CT findings included numerous nodules (42), tumoral masses (28), bronchovascular thickening (35), and pleural effusions (28).
• Less common findings were septal lines (15), ground-glass opacities (3), and mediastinal adenopathies (8).
• The association of nodules, masses, bronchial wall thickening, and pleural effusions was highly characteristic (66%).

Conclusions:

• Thin-section CT is valuable for diagnosing intrathoracic KS in AIDS patients, with nodules, masses, and pleural effusions being key indicators.
• The presence of ground-glass opacities or mediastinal adenopathies on CT may suggest opportunistic infections or mycobacteriosis.
• Combined imaging features, particularly their frequent association, strongly support the diagnosis of intrathoracic KS.