Korean J Intern Med.  2005 Dec;20(4):290-294. 10.3904/kjim.2005.20.4.290.

Clinical and Bronchoscopic Findings in Ugandans with Pulmonary Kaposi's Sarcoma

• Yoo DJ
• Lee KH
• Munderi P
• Shin KC
• Lee JK

• KMID: 1115252
• DOI: http://doi.org/10.3904/kjim.2005.20.4.290

Abstract

BACKGROUND
Pulmonary Kaposi's sarcoma (PKS) directly affects the life expectancy of those infected and yet the clinical and radiographic features of Kaposi's sarcoma (KS) with pulmonary involvement are nonspecific, which makes diagnosis difficult. In Uganda, pulmonary tuberculosis, which has clinical features that closely resemble those of PKS, also occurs commonly and thus confusion is bound to arise. Bronchoscopy is a recognized diagnostic investigatory modality for PKS. The aim of present study was to identify unique or useful points for the differential diagnosis of PKS and other opportunistic infections. METHODS: The clinical, radiologic, and bronchoscopic findings in thirty-five Ugandan patients (age 20-50, median 32) with PKS were analyzed. RESULTS: Cough and weight loss were most common and occurred in 97.1%, whereas fever occurred in 62.9%, and breathlessness in 57.1%. Thirty-four patients (97.1%) showed mucocutaneous KS, and palatal KS was most frequent and was observed in 74.3%. In addition, 25 patients (71.4%) showed the characteristic endobronchial plaques of KS. The most frequently observed radiographic abnormality was bilateral reticulonodular density. Histological examinations of bronchoscopic biopsies revealed KS in 7 (36.6%) cases. Five PFS patients (25%) also had co-existent tuberculosis. CONCLUSIONS: The majority of patients with PKS showed no specific findings on physical examination, apart from mucocutaneous KS. Our findings indicate that palatal KS may be a strong predictor of PKS. In Uganda, pulmonary tuberculosis may be the most common concomitant pulmonary infection in PKS patients.

Keyword

Pulmonary Kaposi's sarcoma; Bronchoscopy; Tuberculosis

MeSH Terms

Uganda
Tuberculosis, Pulmonary/diagnosis
Sarcoma, Kaposi/*diagnosis
Middle Aged
Male
Lung Neoplasms/*diagnosis
Humans
Female
Diagnosis, Differential
*Bronchoscopy
Adult