Pulmonary Kaposi's sarcoma in a patient with the acquired immunodeficiency syndrome

Abstract

Cutaneous Kaposi's sarcoma (KS) is a well-known manifestation of the acquired immunodeficiency syndrome, but pulmonary KS is very rare in Japan. We encountered a 27-year-old Japanese, homosexual man who had extensive pulmonary KS. He came to our hospital because of a cough and dyspnea. On admission, there were some small nodules on the skin, and examination of a biopsy specimen led to the diagnosis of KS. The test for the human immunodeficiency virus antibody was positive and the CD4+ cell count was 69 per cubic millimeter. A radiograph of the chest showed multiple diffuse nodules, linear opacities, and some pleural effusion. Computed tomography also revealed multiple nodules and linear densities distributed along the bronchovascular bundles. Bronchoscopic examination revealed diffuse erythematous changes of the bronchial mucosa with some red polypoid lesions, which was compatible with endobronchial KS. Hypoxia developed one month after bronchoscopy. Two courses of chemotherapy with bleomycin and vincristine were given, and resulted in temporary improvement. A definite diagnosis of KS was made by necropsy.