Answer of August 2004

Clinical History:

A 24-year-old gentleman, ex-smoker, and HIV positive presented with on and off cough for 2 months. CXR showed increased bilateral lung shadows.

Diagnosis:

Kaposi¡¦s sarcoma (KS).

Discussion:

CT scan shows the typical features of pulmonary KS with irregular and ill-defined peribronchovascular flame-shaped nodules and peribronchovascular interstitial thickening in both lungs. There are also interlobular septal thickening, pleural effusions, and mediastinal lymphadenopathy.88% of HIV-infected patient who showed peribronchovascular distribution of nodules had KS. This finding, in association with nodule size larger than 1cm, strongly predicts KS.