Kaposi sarcoma of the lungs in patients with acquired immunodeficiency syndrome (AIDS). Thoracic radiography and scanning

Twenty-four patients with AIDS presenting with Kaposi's sarcoma of the lung were retrospectively studied to assess the merits of thoracic radiographs and of CT for the diagnosis of this disease. Evidence for Kaposi's sarcoma of the lung was given by a characteristic fiberendoscopic appearance in 10 cases and by the histologic diagnosis in 14 cases. All patients had chest radiographs and 14 patients a concomitant thoracic CT study. Chest radiographs showed perihilar opacities in 18 patients, nodules in 8, mediastinal and/or hilar adenopathies in 2 and pleural effusion in 16. Comparison of the patients who had had thoracic radiographs and a CT scan showed better detection of adenopathies, described in 2 cases on chest radiographs and 7 on CT scans, and of nodules, detected in 5 cases on chest radiographs and 6 on CT scans. In 12 patients with perihilar opacities on thoracic radiographs, CT provided a better view of the peribronchovascular distribution of these opaque areas. In 1 patient, CT showed peribronchovascular thickening while radiographs were normal. In 1 patient, both examinations were normal. This study emphasizes the merits of thoracic radiographs and, even more, of CT for the diagnosis of Kaposi's sarcoma of the lung. Peribronchovascular thickening appears to be a characteristic sign that is well analyzed with computed tomography. Since histological evidence of Kaposi's sarcoma is rarely obtained because of the aggressive nature of biopsies in such patients, CT has an important role for the diagnosis of this condition.