title: Fatal pulmonary Kaposi sarcoma in an HIV seronegative AIDS patient.
abstract: BACKGROUND
  Although HIV antibody tests have been widely accepted in clinical diagnosis of HIV infection, they may not be sufficient to diagnose all subjects with HIV infection. Except negative result of antibody test in the well-known" acute window phase", in rare cases, patients do not develop HIV antibodies despite demonstrable infection. Primary pulmonary Kaposi sarcoma (KS) without mucocutaneous involvement accounts for only 0-15% of all AIDS-related KS. KS is rare among Chinese subjects, especially in persons of Han descent.
  
  
  METHODS
  A case of seronegative AIDS with primary pulmonary Kaposi sarcoma (KS) was reported. It's a 46-year-old Chinese man presented with sore throat, hemoptysis, fever, dyspnea and multiple lung nodules. The lung lesions grew over a 5-month period so as the symptoms worsened. The possibility of AIDS was discounted by his physicians because of the repeatedly negative HIV antibodies tests despite the ELISA tests or Western blot tests. Histopathologic diagnosis of fine needle lung biopsy in local hospital was undetermined. After admission, HIV infection was eventually confirmed by plasma HIV RNA testing. Histopathologic diagnosis of Lung Kaposi sarcoma was made through repeated fine needle aspiration biopsy as well as the review of former one. Multiple antibiotics and chemotherapy were administrated with no clinical effect due to advanced stage and the patient passed away soon after diagnosis.
  
  
  RESULTS
  This is the first case of seronegative HIV-1 infection with presentation of primary pulmonary KS.
  
  
  CONCLUSIONS
  This case underscores the importance of plasma RNA test in conjunction with HIV antibody test for some rare patients with HIV infection who present with severe immunodeficiency and opportunistic infections or malignancy.
authors: Departments of Respiratory Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Hong
authors: H
authors: Zhang
authors: Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Huan-Ling
authors: HL
authors: Wang
authors: Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Ding-Rong
authors: DR
authors: Zhong
authors: Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Yan
authors: Y
authors: Liu
authors: Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Ning-Ning
authors: NN
authors: Li
authors: Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Wei
authors: W
authors: Zhang
authors: Departments of Respiratory Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Yi
authors: Y
authors: Xiao
authors: Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
authors: Tai-Sheng
authors: TS
authors: Li
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000175:diagnosis; D017809:Fatal Outcome; D006678:HIV / Q000235:genetics / Q000276:immunology; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000235:genetics; D018023:HIV Seronegativity / Q000276:immunology*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Kaposi sarcoma; pulmonary nodules; seronegative HIV infection