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.To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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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