AIDS-related Kaposi sarcoma of the lung: radiographic findings and staging system with bronchoscopic correlation

To determine the chest radiographic findings in patients with tracheobronchial Kaposi sarcoma (KS) and to develop a radiographic staging system that allows comparison of radiographic to bronchoscopic findings and allows assessment of the typical temporal progression of pulmonary KS.

The chest radiographs and medical records of 76 male patients, aged 23-60 years (mean, 36 years 4 months) with bronchoscopically proved KS were retrospectively reviewed. Tumor extent at bronchoscopy (grade 1-3) was compared with severity of parenchymal disease (radiographic stage 0-3).

There was a statistically significant relationship between extent of tracheobronchial disease and radiographic stage (P = .01). However, in some patients, parenchymal KS of advanced stage was present with no visible endobronchial disease.

The proposed staging system describes features of early, moderate, and advanced KS. Although there is a correlation between tracheobronchial and parenchymal disease, the latter can occur in the absence of endobronchial lesions.