[Diagnostic imaging in AIDS-related pulmonary Kaposi's sarcoma].
BACKGROUND
Kaposi's sarcoma is an uncommon multifocal angiogenic lesion but the most frequent tumor (15%) in HIV+ patients: it is found in homosexual HIV+ men in 95% of cases and appears as cutaneous-mucous lesions in most patients; the respiratory system is involved in 20% of cases. We investigated the yield of conventional radiography, CT and HRCT in the diagnostic imaging of pulmonary Kaposi's sarcoma.


METHODS
We retrospectively reviewed the findings of 205 patients with cutaneous Kaposi's sarcoma. Chest radiography (two projections) had been performed in all of them, chest CT in 23, HRCT in 7, and tracheobronchial endoscopy in 20.


RESULTS
The respiratory system was involved in 22% of the patients with cutaneous-mucous Kaposi's sarcoma. The pulmonary pattern was perivasculobronchial interstitial thickening with bilateral and symmetrical ilifugal involvement in 78% of cases, associated with multiple perivascular nodular opacities (< 1 cm) in 19 patients. Pleural effusion was seen in 52% of cases, while 3 patients had plaque thickening of visceral pleura; mediastinal adenopathy was found in 8.6% of cases. Endoscopy detected 14 tracheobronchial Kaposi's lesions. Kaposi's involvement of the respiratory system was confirmed histologically in 26 autopsy cases.


CONCLUSIONS
In our experience, conventional radiology and clinical-history data permit to evaluate early pleuropulmonary involvement of Kaposi's sarcoma and to follow its evolution. CT and HRCT unquestionably detect the typical signs earlier than conventional radiology and yield further information on disease extent.
Busi Rizzi
E
E
Servizio di Radiologia, Azienda Ospedaliera IRCCS L. Spallanzani, Roma.
Schininà
V
V
Mazzuoli
G
G
Armignacco
O
O
Cecconi
L
L
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000150:complications / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed