Objective:

The article examines the objective, findings, and clinical context described in Pulmonary Kaposi Sarcoma in Advanced HIV With Flame-Like Opacities on Chest CT.

Approach:

• Clinical and imaging assessment: A 61-year-old man with advanced HIV, progressive dyspnea, productive cough, and violaceous skin lesions underwent chest CT.
• Tissue diagnosis: After an initial scant biopsy suggested adenocarcinoma, repeat CT-guided sampling from the left lower lobe and lingula was performed.

Key Findings:

• CT showed bilateral, asymmetric, flame-shaped nodular opacities along peri-bronchovascular regions, predominantly on the left.
• The initial biopsy was limited and showed atypical glandular proliferation concerning for adenocarcinoma.
• Repeat samples showed spindle-cell vascular proliferation and human herpesvirus 8 latent nuclear antigen-1 positivity, confirming Kaposi sarcoma.
• The patient also had Mycobacterium avium complex and Cryptococcus neoformans infections, which were treated.

Interpretation:

The report describes pulmonary Kaposi sarcoma confirmed by repeat biopsy after initial pathology conflicted with the clinical and radiographic findings.

Limitations:

• The initial biopsy specimen was scant and did not permit definitive interpretation.
• This is a single-patient case report.

Conclusion:

The authors state that repeat tissue sampling with human herpesvirus 8 immunohistochemistry should be pursued when pathology conflicts with compelling clinical and imaging findings.

Sources:

• Article context provided