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. 1987 Apr;42(4):262–268. doi: 10.1136/thx.42.4.262

Pulmonary Kaposi's sarcoma in patients with acquired immune deficiency syndrome: a clinicopathological study.

P J Fouret, J L Touboul, C M Mayaud, G M Akoun, J Roland
PMCID: PMC460697  PMID: 3616983

Abstract

Pulmonary Kaposi's sarcoma may contribute to respiratory dysfunction in patients with acquired immune deficiency syndrome (AIDS) and features of pneumonitis. Opportunistic infections are readily recognised in endoscopic material, but pulmonary Kaposi's sarcoma is easily missed, so that patients are deprived of specific treatment. The clinical and pathological findings from nine cases of pulmonary Kaposi's sarcoma have been reviewed; these were found among 84 patients with AIDS and pneumonitis undergoing fibreoptic bronchoscopy and bronchoalveolar lavage. Diagnosis was established before death in eight patients (in five by bronchial biopsy and in three by open lung biopsy). Examination of lavage fluid showed alveolar haemorrhage in six patients. It is concluded that: (1) fibreoptic bronchoscopy may be useful in the diagnosis of endobronchial lesions of Kaposi's sarcoma; (2) alveolar haemorrhage in patients with AIDS is suggestive of pulmonary Kaposi's sarcoma. Factors that may cause difficulties in diagnosis include the focal nature of some lesions and the pleural or parenchymatous location of others. In addition, in the lung as in the skin, the early stages of Kaposi's sarcoma resemble granulation tissue. Such lesions are far more difficult to recognise than is the late nodular stage.

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Selected References

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  1. Ackerman A. B. Subtle clues to diagnosis by conventional microscopy. The patch stage of Kaposi's sarcoma. Am J Dermatopathol. 1979 Summer;1(2):165–172. doi: 10.1097/00000372-197900120-00011. [DOI] [PubMed] [Google Scholar]
  2. Blumenfeld W., Egbert B. M., Sagebiel R. W. Differential diagnosis of Kaposi's sarcoma. Arch Pathol Lab Med. 1985 Feb;109(2):123–127. [PubMed] [Google Scholar]
  3. Broaddus C., Dake M. D., Stulbarg M. S., Blumenfeld W., Hadley W. K., Golden J. A., Hopewell P. C. Bronchoalveolar lavage and transbronchial biopsy for the diagnosis of pulmonary infections in the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Jun;102(6):747–752. doi: 10.7326/0003-4819-102-6-747. [DOI] [PubMed] [Google Scholar]
  4. Brown R. K., Huberman R. P., Vanley G. Pulmonary features of Kaposi sarcoma. AJR Am J Roentgenol. 1982 Oct;139(4):659–660. doi: 10.2214/ajr.139.4.659. [DOI] [PubMed] [Google Scholar]
  5. Drew W. L., Finley T. N., Golde D. W. Diagnostic lavage and occult pulmonary hemorrhage in thrombocytopenic immunocompromised patients. Am Rev Respir Dis. 1977 Aug;116(2):215–221. doi: 10.1164/arrd.1977.116.2.215. [DOI] [PubMed] [Google Scholar]
  6. Fauci A. S., Masur H., Gelmann E. P., Markham P. D., Hahn B. H., Lane H. C. NIH conference. The acquired immunodeficiency syndrome: an update. Ann Intern Med. 1985 Jun;102(6):800–813. doi: 10.7326/0003-4819-102-6-800. [DOI] [PubMed] [Google Scholar]
  7. Fouret P., Touboul J. L., Picard F., Mayaud C., Roland J. Apport de l'examen cytologique du liquide de lavage bronchoalvéolaire chez les patients atteints de syndrome d'immunodéficience acquise et de syndrome associé. Ann Pathol. 1986;6(1):45–52. [PubMed] [Google Scholar]
  8. Friedman-Kien A. E., Laubenstein L. J., Rubinstein P., Buimovici-Klein E., Marmor M., Stahl R., Spigland I., Kim K. S., Zolla-Pazner S. Disseminated Kaposi's sarcoma in homosexual men. Ann Intern Med. 1982 Jun;96(6 Pt 1):693–700. doi: 10.7326/0003-4819-96-6-693. [DOI] [PubMed] [Google Scholar]
  9. Gottlieb G. J., Ackerman A. B. Kaposi's sarcoma: an extensively disseminated form in young homosexual men. Hum Pathol. 1982 Oct;13(10):882–892. doi: 10.1016/s0046-8177(82)80047-6. [DOI] [PubMed] [Google Scholar]
  10. Hanno R., Owen L. G., Callen J. P. Kaposi's sarcoma with extensive silent internal involvement. Int J Dermatol. 1979 Nov;18(9):718–721. doi: 10.1111/j.1365-4362.1979.tb05008.x. [DOI] [PubMed] [Google Scholar]
  11. Hunninghake G. W., Gadek J. E., Kawanami O., Ferrans V. J., Crystal R. G. Inflammatory and immune processes in the human lung in health and disease: evaluation by bronchoalveolar lavage. Am J Pathol. 1979 Oct;97(1):149–206. [PMC free article] [PubMed] [Google Scholar]
  12. Kornfeld H., Axelrod J. L. Pulmonary presentation of Kaposi's sarcoma in a homosexual patient. Am Rev Respir Dis. 1983 Feb;127(2):248–249. doi: 10.1164/arrd.1983.127.2.248. [DOI] [PubMed] [Google Scholar]
  13. Kovacs J. A., Hiemenz J. W., Macher A. M., Stover D., Murray H. W., Shelhamer J., Lane H. C., Urmacher C., Honig C., Longo D. L. Pneumocystis carinii pneumonia: a comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiencies. Ann Intern Med. 1984 May;100(5):663–671. doi: 10.7326/0003-4819-100-5-663. [DOI] [PubMed] [Google Scholar]
  14. Kradin R. L., Mark E. J. Benign lymphoid disorders of the lung, with a theory regarding their development. Hum Pathol. 1983 Oct;14(10):857–867. doi: 10.1016/s0046-8177(83)80161-0. [DOI] [PubMed] [Google Scholar]
  15. Misra D. P., Sunderrajan E. V., Hurst D. J., Maltby J. D. Kaposi's sarcoma of the lung: radiography and pathology. Thorax. 1982 Feb;37(2):155–156. doi: 10.1136/thx.37.2.155. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Murray J. F., Felton C. P., Garay S. M., Gottlieb M. S., Hopewell P. C., Stover D. E., Teirstein A. S. Pulmonary complications of the acquired immunodeficiency syndrome. Report of a National Heart, Lung, and Blood Institute workshop. N Engl J Med. 1984 Jun 21;310(25):1682–1688. doi: 10.1056/NEJM198406213102529. [DOI] [PubMed] [Google Scholar]
  17. Nash G., Fligiel S. Kaposi's sarcoma presenting as pulmonary disease in the acquired immunodeficiency syndrome: diagnosis by lung biopsy. Hum Pathol. 1984 Oct;15(10):999–1001. doi: 10.1016/s0046-8177(84)80130-6. [DOI] [PubMed] [Google Scholar]
  18. Nash G., Fligiel S. Pathologic features of the lung in the acquired immune deficiency syndrome (AIDS): an autopsy study of seventeen homosexual males. Am J Clin Pathol. 1984 Jan;81(1):6–12. doi: 10.1093/ajcp/81.1.6. [DOI] [PubMed] [Google Scholar]
  19. Ognibene F. P., Steis R. G., Macher A. M., Liotta L., Gelmann E., Pass H. I., Lane H. C., Fauci A. S., Parrillo J. E., Masur H. Kaposi's sarcoma causing pulmonary infiltrates and respiratory failure in the acquired immunodeficiency syndrome. Ann Intern Med. 1985 Apr;102(4):471–475. doi: 10.7326/0003-4819-102-4-471. [DOI] [PubMed] [Google Scholar]
  20. Orenstein M., Webber C. A., Cash M., Heurich A. E. Value of bronchoalveolar lavage in the diagnosis of pulmonary infection in acquired immune deficiency syndrome. Thorax. 1986 May;41(5):345–349. doi: 10.1136/thx.41.5.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Pitchenik A. E., Fischl M. A., Saldana M. J. Kaposi's sarcoma of the tracheobronchial tree. Clinical, bronchoscopic, and pathologic features. Chest. 1985 Jan;87(1):122–124. doi: 10.1378/chest.87.1.122. [DOI] [PubMed] [Google Scholar]
  22. Rozenbaum W., Coulaud J. P., Saimot A. G., Klatzmann D., Mayaud C., Carette M. F. Multiple opportunistic infection in a male homosexual in France. Lancet. 1982 Mar 6;1(8271):572–573. doi: 10.1016/s0140-6736(82)92087-6. [DOI] [PubMed] [Google Scholar]
  23. Touboul J. L., Mayaud C. M., Fouret P., Akoun G. M. Pulmonary lesions of Kaposi's sarcoma, intra-alveolar hemorrhage, and pleural effusion. Ann Intern Med. 1985 Nov;103(5):808–808. doi: 10.7326/0003-4819-103-5-808_1. [DOI] [PubMed] [Google Scholar]
  24. Waldo E. Subtle clues to diagnosis by electron microscopy. Kaposi's sarcoma. Am J Dermatopathol. 1979 Summer;1(2):177–180. doi: 10.1097/00000372-197900120-00013. [DOI] [PubMed] [Google Scholar]

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