Kaposi's sarcoma presenting as lymphadenopathy in two HIV-negative elderly patients

Kaposi's Sarcoma Presenting as Lymphadenopathy in an Immunocompetent Patient

Introduction

Kaposi’s sarcoma (KS) is an angioproliferative disorder first described in 1872 by Moritz Kaposi. Four main clinical presentations of KS have been described: classic, endemic, iatrogenic and epidemic. KS involvement of the lymph nodes is extremely uncommon in the classical variant form, especially if it precedes the skin manifestations. We describe the case of an elderly HIV-negative patient presenting with lymphadenopathy who was found to have KS.

Case Report

A 67-year-old patient was admitted for exploration of polyadenopathies in the context of a general decline in health. Physical examination revealed an erythematosus left lower limb rash associated with angiomatous nodules and multiple lymphadenopathies. The diagnosis of erysipelas in the left leg was retained and the patient was treated with good evolution of the rash but persistence of the angiomatous nodules and the polyadenopathies. Skin and lymph node biopsies led to a diagnosis of KS. The patient is proposed for polychemotherapy.

Conclusion

KS must be suspected in lymphadenopathies despite the absence of typical cutaneous signs of the disease and in immunocompetent patients.

LEARNING POINTS

Classic Kaposi's sarcoma with pulmonary involvement in an HIV-negative woman

Visceral involvement in HIV-negative patients with classical Kaposi's sarcoma (KS) has been described only rarely. An unusual case of a 75-year-old Jewish woman with the classical form of KS who presented with cutaneous and pulmonary involvement is presented. Results of several tests for HIV antibodies were negative.