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Mukasine MC, Mulundu G, Kawimbe M, Mutale K, Mumba C, Lidenge SJ, Ngalamika O. Association between KSHV-Specific Humoral and T Cell Responses with Recurrence of HIV-Associated Kaposi Sarcoma. Trop Med Infect Dis 2024; 9:134. [PMID: 38922046 PMCID: PMC11209129 DOI: 10.3390/tropicalmed9060134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/28/2024] [Accepted: 06/11/2024] [Indexed: 06/27/2024] Open
Abstract
Kaposi sarcoma (KS) is an AIDS-defining angio-proliferative malignancy, with the Kaposi sarcoma-associated herpes virus (KSHV) as its etiologic agent. Upon treatment with chemotherapy, a proportion of HIV-associated KS patients experience disease recurrence within a few months of completing treatment. We aimed at determining whether KSHV-specific adaptive immune responses were associated with KS recurrence upon complete remission. We conducted a prospective cohort study. The primary outcome was the recurrence of HIV-associated KS. An immunofluorescence assay was used to determine anti-KSHV antibodies, an enzyme-linked immunospot was conducted for T cell responses, PCR was carried out to determine KSHV status, and flow cytometry was used for CD4 counting and immunophenotyping. KSHV detection in PBMCs was high and not associated with KS recurrence-free survival (p = 0.29). Anti-KSHV antibody titers were high and not associated with recurrence-free survival (p = 0.63). KSHV-specific T cell responses dropped from baseline levels among individuals with recurrence, but the drop was not statistically significant. Individuals experiencing KS recurrence had a significantly higher proportion of T cell subsets expressing PD1, while those with sustained remission had a significant increase in CD4 T cell counts from baseline levels during the follow-up period (p = 0.02). Anti-KSHV antibodies are not a good correlate of protection from KS recurrence. T cells in individuals experiencing KS recurrence hadhigh PD1 expression, while an increase in CD4 counts was associated with sustained KS remission.
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Affiliation(s)
- Marie-Claire Mukasine
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka P.O. Box 50110, Zambia; (M.-C.M.); (G.M.); (C.M.)
- HHV8 Research Molecular Virology Laboratory, University Teaching Hospital, Lusaka P.O. Box 50110, Zambia; (M.K.); (K.M.)
| | - Gina Mulundu
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka P.O. Box 50110, Zambia; (M.-C.M.); (G.M.); (C.M.)
| | - Musonda Kawimbe
- HHV8 Research Molecular Virology Laboratory, University Teaching Hospital, Lusaka P.O. Box 50110, Zambia; (M.K.); (K.M.)
| | - Keagan Mutale
- HHV8 Research Molecular Virology Laboratory, University Teaching Hospital, Lusaka P.O. Box 50110, Zambia; (M.K.); (K.M.)
| | - Chibamba Mumba
- Department of Pathology and Microbiology, University of Zambia School of Medicine, Lusaka P.O. Box 50110, Zambia; (M.-C.M.); (G.M.); (C.M.)
| | - Salum J. Lidenge
- Ocean Road Cancer Institute, Dar es Salaam P.O. Box 3592, Tanzania;
- Department of Clinical Oncology, Muhimbili University of Health and Allied Sciences, Dar es Salaam P.O. Box 65001, Tanzania
| | - Owen Ngalamika
- HHV8 Research Molecular Virology Laboratory, University Teaching Hospital, Lusaka P.O. Box 50110, Zambia; (M.K.); (K.M.)
- Dermatology and Venereology Division, University Teaching Hospital, University of Zambia School of Medicine, Lusaka P.O. Box 50110, Zambia
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Malonga GA, Jary A, Leducq V, Moudiongui Mboungou Malanda D, Boumba ALM, Chicaud E, Malet I, Calvez V, Peko JF, Marcelin AG. Seroprevalence and molecular diversity of Human Herpesvirus 8 among people living with HIV in Brazzaville, Congo. Sci Rep 2021; 11:17442. [PMID: 34465868 PMCID: PMC8408137 DOI: 10.1038/s41598-021-97070-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/19/2021] [Indexed: 12/30/2022] Open
Abstract
Human herpesvirus 8 (HHV8) is endemic in Africa, although studies of this infection are rare in Congo. We evaluated seroprevalence and HHV-8 diversity among people living with HIV. We included 353 patients receiving highly active antiretroviral therapy. Antibodies against HHV-8 latency-associated nuclear antigen were detected by indirect immunofluorescence. In HHV-8 positive patients, we performed HHV-8 quantification in blood and saliva by real-time PCR and typing by Sanger sequencing of K1 open reading frame. HHV-8 seroprevalence was 19%, being male (odd ratio [OR] = 1.741, [95% Confidence interval {CI}, 0.97-3.07]; p = 0.0581) and having multiple sex partners before HIV diagnosis (OR = 1.682, [CI 95%, 0.97-2.92]; p = 0.0629) tended to be associated with HHV-8 seropositivity. Of the 64 HHV-8 seropositive patients, HHV-8 DNA was detected in 10 (16%) in saliva, 6 (9%) in whole-blood and in 2 (3%) in both whole-blood and saliva. Three out of 6 HHV-8 strains were subtypes A5, 2 subtype B1 and 1 subtype C. HHV-8 seroprevalence was relatively low with more frequent carriage in men, associated with asymptomatic oral excretion and a predominance of subtype A5. These data tend to support the hypothesis of horizontal transmission in people living with HIV in Brazzaville.
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Affiliation(s)
- Gervillien Arnold Malonga
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France.
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo.
| | - Aude Jary
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Valentin Leducq
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Dimitry Moudiongui Mboungou Malanda
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire de Brazzaville, Brazzaville, Republic of Congo
| | - Anicet Luc Magloire Boumba
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo
- Laboratoire d'Analyses Médicales, Hôpital Général de Loandjili, Pointe-Noire, Republic of Congo
| | - Elodie Chicaud
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Isabelle Malet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Vincent Calvez
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
| | - Jean Felix Peko
- Faculté des Sciences de la Santé, Université Marien Ngouabi, Brazzaville, Republic of Congo
- Service d'Anatomie et Cytologie Pathologiques, Centre Hospitalier Universitaire de Brazzaville, Brazzaville, Republic of Congo
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique - Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Pitié-Salpêtrière - Charles Foix, Laboratoire de Virologie, Department of Virology - CERVI, Pitié-Salpêtrière Hospital, 83 boulevard de l'Hôpital, 75013, Paris, France
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Demba RN, Shaviya N, Aradi SM, Mwanda W. Selected genes of Human herpesvirus-8 associated Kaposi's sarcoma among patients with Human Immunodeficiency Virus-1 and Acquired Immunodeficiency Disease Syndrome. Pan Afr Med J 2019; 32:215. [PMID: 31404285 PMCID: PMC6675582 DOI: 10.11604/pamj.2019.32.215.17322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 04/14/2019] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Kaposi's sarcoma (KS) is a kind of cancer that causes flat or raised lesions containing Human herpes virus 8 (HHV8). The KS lesions are common among immunosuppressed HIV patients. Highly Active Antiretroviral (HHART) treats and prevents the development of KS. The objective of this study was to determine the presence of K1 and K15 (predominant alleles) genes in Kaposi's sarcoma-associated herpes virus (KSHV) among immunosuppressed patients due to HIV-1. METHODS This was a cross-sectional descriptive study where consecutive sampling technique was adopted to pick archived tissue blocks from the Thematic Unit of Anatomic Pathology, Department of Human Pathology, College of Health Sciences, University of Nairobi and Department of Laboratory Medicine, Histology Section, Kenyatta National Hospital. RESULTS Upon staining 81 tissue blocks with H & E, 84% (68/81) were diagnosed as KS and 16% (13/81) as KS-like. The K1 and K15 (P) genes were both detected at 88.9% (72/81) in the tissue blocks, with 95.8% (69/72) detection from KS and 4.2% (3/72) from the KS-like. CONCLUSION The K1 and K15 (P) genes of KSHV were present among the immunosuppressed patients with Human Immunodeficiency Virus (HIV)-1. It is important to carry out K1 and K15 (P) genes detection on tissues that are diagnosed as KS or KS-like by histology technique.
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Affiliation(s)
- Rodgers Norman Demba
- School of Health Sciences, Kisii University, Kisii, Kenya
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
| | - Nathan Shaviya
- Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | | | - Walter Mwanda
- Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya
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Tembo R, Kaile T, Kafita D, Chisanga C, Kalonda A, Zulu E, Samutela M, Polepole P, Kwenda G. Detection of Human Herpes Virus 8 in Kaposi's sarcoma tissues at the University Teaching Hospital, Lusaka, Zambia. Pan Afr Med J 2017; 27:137. [PMID: 28904666 PMCID: PMC5567952 DOI: 10.11604/pamj.2017.27.137.11845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 06/15/2017] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Human herpes virus-8, a γ2-herpes virus, is the aetiological agent of Kaposi sarcoma. Recently, Kaposi's sarcoma cases have increased in Zambia. However, the diagnosis of this disease is based on morphological appearance of affected tissues using histological techniques, and the association with its causative agent, Human Herpes virus 8 is not sought. This means poor prognosis for affected patients since the causative agent is not targeted during diagnosis and KS lesions may be mistaken for other reactive and neoplastic vascular proliferations when only histological techniques are used. Therefore, this study was aimed at providing evidence of Human Herpes virus 8 infection in Kaposi's sarcoma tissues at the University Teaching Hospital in Lusaka, Zambia. METHODS One hundred and twenty suspected Kaposi's sarcoma archival formalin-fixed paraffin-wax embedded tissues stored from January 2013 to December 2014 in the Histopathology Laboratory at the University Teaching Hospital, Lusaka, Zambia were analysed using histology and Polymerase Chain Reaction targeting the ORF26 gene of Human Herpes virus 8. RESULTS The predominant histological type of Kaposi's sarcoma detected was the Nodular type (60.7%) followed by the plaque type (22.6%) and patch type (16.7%). The nodular lesion was identified mostly in males (40.5%, 34/84) than females (20.2%, 17/84) (p=0.041). Human Herpes virus 8 DNA was detected in 53.6% (45/84) and mostly in the nodular KS lesions (60%, 27/84) (p=0.035). CONCLUSION The findings in this study show that the Human Herpes virus-8 is detectable in Kaposi's sarcoma tissues, and, as previously reported in other settings, is closely associated with Kaposi's sarcoma. The study has provided important baseline data for use in the diagnosis of this disease and the identification of the virus in the tissues will aid in targeted therapy.
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Affiliation(s)
- Rabecca Tembo
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Trevor Kaile
- Department of Pathology and Microbiology, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Doris Kafita
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Chrispin Chisanga
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Annie Kalonda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Ephraim Zulu
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Mulemba Samutela
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Pascal Polepole
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
| | - Geoffrey Kwenda
- Department of Biomedical Sciences, School of Health Sciences, University of Zambia, Lusaka, Zambia
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Mansfield SA, Stawicki SPA, Forbes RC, Papadimos TJ, Lindsey DE. Acute upper gastrointestinal bleeding secondary to Kaposi sarcoma as initial presentation of HIV infection. JOURNAL OF GASTROINTESTINAL AND LIVER DISEASES : JGLD 2013; 22:441-445. [PMID: 24369327 PMCID: PMC4097021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Despite our decades of experience with Kaposi Sarcoma its true nature remains elusive. This angioproliferative disease of the vascular endothelium has a propensity to involve visceral organs in the immunocompromised population. There are four variants of the disease and each has its own pathogenesis and evolution. While the common sources of upper gastrointestinal bleeding are familiar to surgeons and critical care physicians, here we present the exceedingly rare report of upper gastrointestinal bleeding attributable to this malady, explore its successful management, and review the various forms of Kaposi Sarcoma including the strategies in regard to their management.
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MESH Headings
- Antineoplastic Agents, Phytogenic
- Antiretroviral Therapy, Highly Active
- Biomarkers, Tumor/analysis
- CD4 Lymphocyte Count
- Endoscopy, Digestive System
- Erythrocyte Transfusion
- Female
- Gastrointestinal Hemorrhage/etiology
- Gastrointestinal Hemorrhage/therapy
- HIV Infections/complications
- HIV Infections/diagnosis
- HIV Infections/drug therapy
- HIV Infections/virology
- Humans
- Immunoglobulins, Intravenous/therapeutic use
- Middle Aged
- Mouth Neoplasms/chemistry
- Mouth Neoplasms/diagnosis
- Mouth Neoplasms/drug therapy
- Mouth Neoplasms/virology
- Multimodal Imaging
- Paclitaxel/therapeutic use
- Positron-Emission Tomography
- Purpura, Thrombocytopenic, Idiopathic/drug therapy
- Purpura, Thrombocytopenic, Idiopathic/virology
- Sarcoma, Kaposi/chemistry
- Sarcoma, Kaposi/diagnosis
- Sarcoma, Kaposi/drug therapy
- Sarcoma, Kaposi/virology
- Stomach Neoplasms/chemistry
- Stomach Neoplasms/diagnosis
- Stomach Neoplasms/drug therapy
- Stomach Neoplasms/virology
- Tomography, X-Ray Computed
- Treatment Outcome
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Affiliation(s)
- Sara A Mansfield
- Department of Surgery, Division of Trauma, Critical Care, and Burn, The Ohio State University College of Medicine, Columbus, OH, USA;
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Brasil CDMV, Ribeiro CMB, Leão JC. Oral and genital human herpesvirus 8 and human papillomavirus in heterosexual partners. J Oral Pathol Med 2012; 42:61-5. [PMID: 22680306 DOI: 10.1111/j.1600-0714.2012.01184.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The purpose of this study was to verify a possible co-infection of human herpesvirus 8 (HHV-8) in commonly associated human papillomavirus (HPV) penile lesions and to determine the frequency of detection of these viruses in the oral mucosa of their female counterparts. METHODS Thirty-one male subjects underwent penile swabs from clinical HPV-related lesions. Their female counterparts underwent swabs of the vagina, uterine cervix, and oral mucosa. HPV and HHV-8 detection was performed by polymerase chain reaction using the consensus primers MY11/MY09 and KS1/KS2, respectively. RESULTS HPV DNA was detected in 31/31 penile lesions. HPV DNA was also detected in 18/31 (58%) female genital brushings and 17/31 (54%) female oral brushings. HHV-8 DNA was detected in 1/31 (3.2%) male genital brushings and 3/31 (9.6%) female oral mucosa brushings. None of the female genital brushings were HHV-8 DNA-infected. CONCLUSIONS Based upon the results of this study, co-infection between HPV and HHV-8 in malignant and pre-malignant penile lesions is an unlikely finding.
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Affiliation(s)
- Catarina da Mota Vasconcelos Brasil
- Departmento de Clínica e Odontologia Preventiva, School of Dentistry, Oral Medicine Unit, Universidade Federal de Pernambuco/UFPE, Recife, PE, Brazil
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de França TRT, de Araújo RA, Ribeiro CMB, Leao JC. Salivary shedding of HHV-8 in people infected or not by human immunodeficiency virus 1. J Oral Pathol Med 2010; 40:97-102. [DOI: 10.1111/j.1600-0714.2010.00959.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Gasparetto TD, Marchiori E, Lourenço S, Zanetti G, Vianna AD, Santos AASMD, Nobre LF. Pulmonary involvement in Kaposi sarcoma: correlation between imaging and pathology. Orphanet J Rare Dis 2009; 4:18. [PMID: 19602252 PMCID: PMC2720383 DOI: 10.1186/1750-1172-4-18] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Accepted: 07/14/2009] [Indexed: 12/11/2022] Open
Abstract
Kaposi sarcoma is a low-grade mesenchymal tumor involving blood and lymphatic vessels. There are four variants of this disease, each presenting a different clinical manifestation: classic or sporadic, African or endemic, organ transplant-related or iatrogenic, and AIDS-related or epidemic. Kaposi sarcoma is the most common tumor among patients with HIV infection, occurring predominantly in homosexual or bisexual men. The pulmonary involvement in Kaposi sarcoma occurs commonly in critically immunosupressed patients who commonly have had preceding mucocutaneous or digestive involvement. The etiology of Kaposi sarcoma is not precisely established; genetic, hormonal, and immune factors, as well as infectious agents, have all been implicated. There is evidence from epidemiologic, serologic, and molecular studies that Kaposi sarcoma is associated with human herpes virus type 8 infection. The disease starts as a reactive polyclonal angioproliferative response towards this virus, in which polyclonal cells change to form oligoclonal cell populations that expand and undergo malignant transformation. The diagnosis of pulmonary involvement in Kaposi sarcoma usually can be made by a combination of clinical, radiographic, and laboratory findings, together with the results of bronchoscopy and transbronchial biopsy. Chest high-resolution computed tomography scans commonly reveal peribronchovascular and interlobular septal thickening, bilateral and symmetric ill-defined nodules in a peribronchovascular distribution, fissural nodularity, mediastinal adenopathies, and pleural effusions. Correlation between the high-resolution computed tomography findings and the pathology revealed by histopathological analysis demonstrate that the areas of central peribronchovascular infiltration represent tumor growth involving the bronchovascular bundles, with nodules corresponding to proliferations of neoplastic cells into the pulmonary parenchyma. The interlobular septal thickening may represent edema or tumor infiltration, and areas of ground-glass attenuation correspond to edema and the filling of air spaces with blood. These findings are a result of the propensity of Kaposi sarcoma to grow in the peribronchial and perivascular axial interstitial spaces, often as continuous sheets of tumor tissue. In conclusion, radiological findings can play a major role in the diagnosis of pulmonary Kaposi sarcoma since characteristic patterns may be observed. The presence of these patterns in patients with AIDS is highly suggestive of Kaposi sarcoma.
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