Computed tomography staging system and Clinicopathology of pulmonary Kaposi's sarcoma associated with acquired immunodeficiency syndrome: a retrospective study of 53 cases

Abstract Objectives The aim of this study is to understand the CT manifestations of pulmonary Kaposi's sarcoma (pKS) through dynamic observation, in order to promote its clinical diagnosis and treatment. Materials and Methods Collected medical records and CT images of 93 AIDS-KS patients, 53 of whom had pKS. Two senior physicians analyzed lung CT images respectively which the first time diagnosis of pKS (53 cases) and reexamined after treatment (39 cases). Results 51 cases had cutaneous KS, 41 cases had digestive tract KS, 3 cases had lymph node KS. According to the evolution of pKS, the CT manifestations of AIDS related pKS can be divided into three stages: I: Bronchial vascular thickening stage (6 cases); II: 24 cases in the nodular stage; III: Fusion consolidation period (23 cases). The complications of pulmonary KS include lymphadenopathy, pleural and pericardial effusion, subcutaneous edema, and bone destruction/metastasis.The prognosis of 39 patients treated with highly active antiretroviral treatment (HAART) and paclitaxel were: I: 100% being remission; II: 70.6% being remission ,23.5% being progression; 5.9% no change after treatment; III: 72.2% being remission; 22.2% being progression; 5.6% no change after treatment. Conclusions When AIDS related KS affects the lungs, it often presents as systemic disseminated KS. CT images of pKS could be divided into three stages. Recognizing CT staging of pKS is of help to guide clinical diagnosis early and mastery of the disease course to achieve disease control.