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Pelidis MA, Bathobakae L, Aiken A, Villegas K, Mohtadi M, Rezkalla A, Mateen N, Mhanna H, Ismail M, Michael P. Pulmonary Kaposi Sarcoma in the Era of Antiretroviral Therapy: A Case Series. J Med Cases 2024; 15:311-318. [PMID: 39421229 PMCID: PMC11483144 DOI: 10.14740/jmc4251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 09/04/2024] [Indexed: 10/19/2024] Open
Abstract
Kaposi sarcoma (KS) is an angioproliferative neoplasm that affects the skin and lymph nodes. Human herpesvirus-8 (HHV-8) triggers KS by infecting the endothelium and inducing angiogenesis through the production of vascular endothelial growth factors and cytokines. KS is characterized by purplish or hyperpigmented plaques involving the skin and mucous membranes, and visceral involvement is very rare. Pulmonary KS (PKS) is an exceedingly rare visceral manifestation of KS and has a poor prognosis. PKS often presents with cough, hemoptysis, pleuritic chest pain, fever, and weight loss. In this case series, we share our experience in diagnosing and treating two patients with PKS. We also provide a concise review of the epidemiology, signs and symptoms, diagnosis, and management of this rare condition.
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Affiliation(s)
| | - Lefika Bathobakae
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Arielle Aiken
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Katrina Villegas
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Malina Mohtadi
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Abraam Rezkalla
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Nargis Mateen
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Hussein Mhanna
- Pulmonary & Critical Care Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Medhat Ismail
- Pulmonary & Critical Care Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
| | - Patrick Michael
- Internal Medicine, St. Joseph’s University Medical Center, Paterson, NJ, USA
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Micali C, Russotto Y, Facciolà A, Marino A, Celesia BM, Pistarà E, Caci G, Nunnari G, Pellicanò GF, Venanzi Rullo E. Pulmonary Kaposi Sarcoma without Respiratory Symptoms and Skin Lesions in an HIV-Naïve Patient: A Case Report and Literature Review. Infect Dis Rep 2022; 14:228-242. [PMID: 35447880 PMCID: PMC9025598 DOI: 10.3390/idr14020028] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Kaposi sarcoma (KS) is a multifocal lympho-angioproliferative, mesenchymal low-grade tumor associated with a γ2-herpesvirus, named Kaposi sarcoma-associated virus or human herpesvirus (KSHV/HHV8). The lung is considered a usual anatomical location of KS, despite being infrequent, often in association with extensive mucocutaneous lesions and very uncommonly as an isolated event. We report a case of a pulmonary KS (pKS) in a human immunodeficiency virus (HIV) naïve patient, which was atypical due to a lack of cutaneous involvement and an absence of respiratory symptoms. The pKS was initially identified as a tumoral suspected nodular lesion and only after immunohistochemical analysis was it characterized as KS. Furthermore, the diagnosis of pKS led to the discovery of the HIV-seropositive status of the patient, previously unknown. Our report underlines the importance of considering pKS even without skin lesions and as a first manifestation of HIV infection. We also reviewed literature on the current knowledge about pKS in people living with HIV (PLWH) to underline how one of the most common HIV/acquired immunodeficiency syndrome (AIDS) associated tumors can have a challenging localization and be difficult to recognize.
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Affiliation(s)
- Cristina Micali
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (C.M.); (G.C.); (G.N.); (E.V.R.)
| | - Ylenia Russotto
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (C.M.); (G.C.); (G.N.); (E.V.R.)
| | - Alessio Facciolà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98100 Messina, Italy;
| | - Andrea Marino
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy; (A.M.); (B.M.C.); (E.P.)
| | - Benedetto Maurizio Celesia
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy; (A.M.); (B.M.C.); (E.P.)
| | - Eugenia Pistarà
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Catania, 95131 Catania, Italy; (A.M.); (B.M.C.); (E.P.)
| | - Grazia Caci
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (C.M.); (G.C.); (G.N.); (E.V.R.)
| | - Giuseppe Nunnari
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (C.M.); (G.C.); (G.N.); (E.V.R.)
| | - Giovanni Francesco Pellicanò
- Unit of Infectious Diseases, Department of Adult and Childhood Human Pathology “Gaetano Barresi”, University of Messina, 98124 Messina, Italy;
| | - Emmanuele Venanzi Rullo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Messina, 98124 Messina, Italy; (C.M.); (G.C.); (G.N.); (E.V.R.)
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