Season 8 Case 32

Season 8 Apr 6, 2020

History: cough, shortness of breath, fever


Season 8 Case 32

History: cough, shortness of breath, fever 

 

Answer: Kaposi’s Sarcoma


KS is a low-mid grade mesenchymal tumor that involves blood/lymphatic vessels of the skin, lymph nodes, lungs, GI tract, etc. Not considered a true “sarcoma”. Believed related to human herpes virus type 8 (HHV8)

Comes in 4 variants:

Classic - generally limited to lower limb w/ purple dermal plaques

Iatrogenic - related to immunosuppression during organ transplantation

AIDS-related - HIV+ patients with CD4 <200 (considered an AIDS defining illness)

Endemic - men in equatorial Africa


Imaging: 

XR – linear interstitial nodules vs fluffy ill-defined nodules often in a peri-hilar to mid/lower lung predominance.  +pleural effusion + adenopathy

CT - flame shaped nodular opacities in a symmetric/perihilar distribution often with surrounding glass-glass appearance +adneopathy (?high attentuation)

Nucs - can be helpful to differentiate from lymphoma

Th-201 is positive in both KS and lymphoma

Ga67 usually negative in KS but positive in lymphoma/infection

Tags

WetReadRad

Professor of the Darkroom Arts

Great! You've successfully subscribed.
Great! Next, complete checkout for full access.
Welcome back! You've successfully signed in.
Success! Your account is fully activated, you now have access to all content.