Pulmonary involvement in AIDS-related Kaposi sarcoma
- Kevin R Flaherty, MD, MS
Kevin R Flaherty, MD, MS
- Section Editor — Interstitial Lung Disease
- Associate Professor of Medicine
- University of Michigan Health System
- Section Editor
- John G Bartlett, MD
John G Bartlett, MD
- Editor-in-Chief — Infectious Diseases
- Section Editor — HIV; Pulmonary Infections
- Professor Emeritus
- Johns Hopkins University School of Medicine
AIDS-related Kaposi sarcoma (KS) is a low-grade vascular tumor associated with human herpesvirus 8 (HHV-8), which is also known as the Kaposi sarcoma-associated herpesvirus (KSHV). HHV-8 is also causally linked to primary effusion lymphoma and multicentric Castleman’s disease. The widespread application of potent combination antiretroviral therapy (ART) has led to a striking decrease in the incidence of KS and has changed its natural history .
The clinical manifestations, diagnosis, and complications of pulmonary AIDS-associated KS are discussed here. Other aspects of AIDS-related KS are reviewed separately. (See "AIDS-related Kaposi sarcoma: Clinical manifestations and diagnosis" and "AIDS-related Kaposi sarcoma: Staging and treatment" and "Virology, epidemiology, and transmission of human herpesvirus 8 infection", section on 'Virology and pathogenesis'.)
In 80 to 90 percent of cases, pulmonary involvement with KS occurs in conjunction with more extensive mucocutaneous disease [2,3]. However, pulmonary involvement can be the initial manifestation of KS and occurs in the absence of mucocutaneous disease in 15 percent .
Pulmonary KS can involve the lung parenchyma, airways, pleura, and/or intrathoracic lymph nodes. There are no unique manifestations that distinguish KS from other pathologic processes in the lungs.
●Parenchymal lung involvement is usually manifest clinically by dyspnea, hypoxemia, and dry cough developing over a few weeks . Hemoptysis, fever, fatigue and occasionally respiratory failure can also occur.
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- CLINICAL MANIFESTATIONS
- Thoracentesis and pleural biopsy
- Pulmonary parenchymal and endobronchial disease
- Pleural disease
- DIFFERENTIAL DIAGNOSIS
- Systemic treatment
- Airway obstruction and bleeding
- Pleural effusions
- SUMMARY AND RECOMMENDATIONS