Presentation
Synthesizing disparate information into a readily accessible format, this insightful volume presents state-of-the-art reviews on the basic and clinical features of pulmonary diseases in HIV-infected individuals-informing critical decision making as well [books.google.com]
Discussion In sub-Saharan Africa, where many patients access ART with advanced HIV disease, AIDS-related KS presents with a high tumour burden and rapid disease progression, resulting in a life expectancy of 1 KS involving the lung presents as shortness [sajhivmed.org.za]
Case Presentation A 40 year-old HIV positive homosexual male not on HAART Therapy presents with a 1month history of intractable cough, hemoptysis and shortness of breath. [austinpublishinggroup.com]
Associated simultaneous pulmonary diseases were present in nine (36.0%) cases: tuberculosis in three, Pneumocystis carinii pneumonia in three, atypical mycobacterial disease in two, and bacterial pneumonia in one. [journals.lww.com]
Entire Body System
- Lymphadenopathy
(may be present in up to 50%) 5 lymphadenopathy is typically of high attenuation 6 On liver CT: ill-defined multifocal peripheral portal nodules with variable attenuation (commonest hepatic neoplasm in AIDS patients) 1,4 Nuclear medicine Scintigraphy [radiopaedia.org]
All the children had mediastinal and axillary lymphadenopathy; 75% had bilateral hilar lymphadenopathy. Conclusion In both adults and children, chest radiography demonstrates perihilar and lower zone involvement. [link.springer.com]
Mediastinal and hilar lymphadenopathy were not detected in any of the four subjects. [ajronline.org]
On exam he appeared malnourished with oral thrush, and exhibited axillary and inguinal lymphadenopathy. Anal tenderness precluded a digital rectal exam. Skin did not show rash. [acgcasereports.gi.org]
- Inflammation
They may become painful if there is inflammation or swelling. There may be a superimposed or secondary bacterial infection over the skin lesions. [news-medical.net]
Computed tomography (CT) of abdomen demonstrated inflammation and fluid surrounding the rectum (proctitis) and diffuse adenopathy involving the retroperitoneal and mesenteric lymph nodes. Empirical antibiotics were initiated. [acgcasereports.gi.org]
There may also be surrounding inflammation. Investigations Definitive diagnosis is based on biopsy features with the presence of spindle cells. [patient.info]
Inflammation around the tumor may produce swelling and pain. Variously sized PAS positive hyaline bodies are often seen in the cytoplasm or sometimes extracellularly. [en.wikipedia.org]
- Anemia
[…] supplementation) and blood transfusions are used to conservatively manage BRBNS because of the amount of blood that is lost from the GI bleeding. [9] It is not necessary to remove the lesions in the gastrointestinal system unless the bleeding leads to anemia [en.wikipedia.org]
Despite aggressive measures, his condition continued to deteriorate, leading to pulmonary edema and pleural effusion requiring mechanical ventilation, multi-factorial kidney failure requiring dialysis, anemia, and coagulopathy from worsening liver failure [acgcasereports.gi.org]
The immune system can be weakened by diseases like AIDS (acquired immunodeficiency syndrome), Castleman disease or hemolytic anemia. It can also be weakened by immune-suppressing drugs such as those taken after an organ transplant. [cancer.ca]
Respiratoric
- Cough
Symptoms and signs of pulmonary KS include dyspnea (difficulty breathing), fever, non-productive cough, and hemoptysis (coughing up blood). [secure.ssa.gov]
Case Presentation A 40 year-old HIV positive homosexual male not on HAART Therapy presents with a 1month history of intractable cough, hemoptysis and shortness of breath. [austinpublishinggroup.com]
[…] reticulonodular pulmonary infiltrates, solitary lung nodules, or pleural effusions Tumor follows lymphatic channels Detection of HHV8 DNA is highly specific and sensitive for diagnosis of pulmonary Kaposi sarcoma Case reports 42 year old HIV+ man with chronic coughing [pathologyoutlines.com]
Washington, DC, USA 2 Department of Pulmonary Critical Care, US Department of Veterans Affairs, Washington, DC, USA Correspondence to Dr Ahmad Alwassia, alwassia5{at}hotmail.com Summary The patient in our case presented with progressive dyspnoea and cough [casereports.bmj.com]
- Pleural Effusion
[…] nodularity, and pleural effusion. [ajronline.org]
Pleural effusion was noted in eight of 22 cases in the literature and in three of the nine cases in the current series. [ncbi.nlm.nih.gov]
Definition / general Usually associated with AIDS, HHV8 infection; also immunocompromise, organ transplant Diffuse reticulonodular pulmonary infiltrates, solitary lung nodules, or pleural effusions Tumor follows lymphatic channels Detection of HHV8 DNA [pathologyoutlines.com]
Pleural effusion was seen in 52% of cases, while 3 patients had plaque thickening of visceral pleura; mediastinal adenopathy was found in 8.6% of cases. Endoscopy detected 14 tracheobronchial Kaposi's lesions. [moh-it.pure.elsevier.com]
- Pneumonia
Until the diagnosis of KS was confirmed, the patient was treated with broad-spectrum antibiotics for severe community-acquired pneumonia as well as coverage for Pneumocystis jirovecii pneumonia. [ncbi.nlm.nih.gov]
Associated simultaneous pulmonary diseases were present in nine (36.0%) cases: tuberculosis in three, Pneumocystis carinii pneumonia in three, atypical mycobacterial disease in two, and bacterial pneumonia in one. [journals.lww.com]
There is also a serum antigen for Streptococcus pneumonia that can be tested in PLWH suspected of having pneumonia. [clinicaladvisor.com]
Transbronchial lung biopsy (TBLB) revealed histological findings reported in lymphocytic interstitial pneumonia. [jlc.jst.go.jp]
- Hemoptysis
Symptoms and signs of pulmonary KS include dyspnea (difficulty breathing), fever, non-productive cough, and hemoptysis (coughing up blood). [secure.ssa.gov]
Hemoptysis may occur but is unusual. [emedicine.medscape.com]
Case Presentation A 40 year-old HIV positive homosexual male not on HAART Therapy presents with a 1month history of intractable cough, hemoptysis and shortness of breath. [austinpublishinggroup.com]
- Aspiration
Fine-needle aspiration (FNA) biopsy : A thin needle is used to remove part of a skin growth. An endoscopy or bronchoscopy may be done to check for Kaposi sarcoma lesions in the gastrointestinal tract or lungs. [cancer.gov]
The diagnosis was confirmed with fine-needle aspiration biopsy of the left upper lobe mass. Figure 8b. Pulmonary KS in a 45-year-old man. [pubs.rsna.org]
Angiosarcoma at unusual sites: a report of two cases with aspiration cytology and diagnostic pitfalls. Acta Cytol 1997; 41 : 839–844. 16 Naka N, Ohsawa M, Tomita Y, et al. Prognostic factors in angiosarcoma: a multivariate analysis of 55 cases. [nature.com]
Non-Hodgkin lymphoma Endobronchial ultrasound with transbronchial needle aspiration can be used to make the diagnosis if there is mediastinal lymphadenopathy. [clinicaladvisor.com]
Liver, Gall & Pancreas
- Jaundice
In case of liver metastasis there are signs of liver damage like jaundice etc. Lesions occurring in the oesophagus (food pipe) or respiratory tract may grow to obstruct feeding or breathing respectively. [news-medical.net]
Further, he developed hypoxia, jaundice, and abnormal liver tests (total bilirubin 10.2 mg/dL, alkaline phosphatase 344 U/L, aspartate transaminase 421 U/L, and alanine transaminase 116 U/L), and a repeat non-contrast CT scan demonstrated multiple new [acgcasereports.gi.org]
(Rutaceae), a dioecious shrub with hooked prickly branches, has been used as folk medicine for the treatment of the common cold, stomach ache, diarrhea, and jaundice in China, Korea, and Japan. [cancerindex.org]
Cardiovascular
- Chest Pain
This can cause: uncomfortable swelling in the arms or legs (lymphoedema) breathlessness, coughing up blood, and chest pain nausea, vomiting, stomach pain, and diarrhoea How quickly the symptoms progress depends on the type of Kaposi's sarcoma. [nhs.uk]
These symptoms include dyspnea, hemoptysis, chest pain, and malaise ( 10, 13, 14 ). [nature.com]
Fever (62.9%), breathlessness (57.1%), hemoptysis, and chest pain (31.4%) followed. Chest pains were usually retrosternal in nature and this was aggravated by coughing ( Table 1 ). [kjim.org]
A routine chest X-ray (CXR) revealed bilateral opacities infiltrating predominantly the perihilar peribronchovascular interstitium of both lungs (Fig. 1). Fig. 1. [sajhivmed.org.za]
On admission, he denied fever, chills, chest pain, sick contacts, recent travel, or tuberculosis exposure and history. [f1000research.com]
- Vascular Disease
Hammar Springer Science & Business Media, 29 Jun 2013 - Medical - 1656 pages The first edition of Pulmonary Pathology was dedicated to Vascular Diseases. Vasculitis is so complex as to con two giants in the field, Drs. [books.google.com]
Initial clinical diagnostic impressions included pericarditis, vasculitis due to a collagen vascular disease, interstitial pneumonia, sarcoidosis, and metastatic adenocarcinoma ( n = 13). [nature.com]
Cardiovascular late side effects have been termed radiation-induced heart disease (RIHD) and radiation-induced vascular disease (RIVD). [24] Symptoms are dose dependent and include cardiomyopathy, myocardial fibrosis, valvular heart disease, coronary [en.wikipedia.org]
Skin
- Sweating
He had associated night sweats, 5 month history of generalized skin lesions and 30 pound weight loss over 1 year. Physical examination revealed a non blanching purple skin lesion on the face, arms, legs and soles of both feet. [austinpublishinggroup.com]
Other symptoms can include tiredness and energy loss (fatigue), night sweats and weight loss. [cancervic.org.au]
During this time, the patient may have had non-specific symptoms such as fever, weight loss and sweating. Possibly there were other illnesses, such as lymphoma or tuberculosis, before the first KS lesion developed. [healthcentral.com]
These include swollen lymph nodes night sweats fevers fatigue weight loss. If you are at risk of HIV, your doctor will recommend a blood test to check for this virus. [drugs.com]
- Night Sweats
He had associated night sweats, 5 month history of generalized skin lesions and 30 pound weight loss over 1 year. Physical examination revealed a non blanching purple skin lesion on the face, arms, legs and soles of both feet. [austinpublishinggroup.com]
Other symptoms can include tiredness and energy loss (fatigue), night sweats and weight loss. [cancervic.org.au]
These include swollen lymph nodes night sweats fevers fatigue weight loss. If you are at risk of HIV, your doctor will recommend a blood test to check for this virus. [drugs.com]
Thus when our patient was diagnosed with pulmonary KS, it was indicative of systemic disease and explained her symptoms such as fever, drenching night sweats and weight loss. These cytokine driven responses are always a poor prognostic sign. [immunopaedia.org.za]
- Skin Plaque
There are four recognized variants 1 : classic (chronic): multiple distal lower extremity predominant purple skin plaques and rarely involve visceral organs endemic (lymphadenopathic): common in equatorial Africa iatrogenic (organ transplant-related) [radiopaedia.org]
Workup
In this series, four patients with pericardial effusions were at first thought to have nonneoplastic disease, the workups of whom included two negative bloody pericardial fluid cytology exams, and two patients were initially treated with prednisone for [nature.com]
X-Ray
- Pulmonary Infiltrate
[…] along septa and infiltration of small airways, pulmonary arteries, veins Microscopic (histologic) images Images hosted on PathOut server : Case of the Week #336 : Back to top [pathologyoutlines.com]
Other infections The endemic mycoses can present with pulmonary infiltrates and often have associated mediastinal lymphadenopathy. Imaging characteristics of IPA include nodules, cavitary lesions, and infiltrates. [clinicaladvisor.com]
Kaposi’s sarcoma causing pulmonary infiltrates and respiratory failure in the acquired immunodeficiency syndrome. Ann Intern Med 1985 ;102:471–475. [pubs.rsna.org]
- Multiple Pulmonary Nodules
: A patient with HIV, dyspnea, and multiple pulmonary nodules: pulmonary Kaposi sarcoma. Chest. 2006; 130 (6): 1924–8. PubMed Abstract | Publisher Full Text 18. [f1000research.com]
Pulmonary KS in a 45-year-old man. (a) Chest radiograph shows multiple bilateral ill-defined nodules (arrowheads indicate nodules on the right side). Two indistinct masses (arrows) are identified in the left hemithorax. [pubs.rsna.org]
- Air Bronchogram
bronchograms; fissural nodularity; ground-glass opacities (Figure 4 ); mediastinal adenopathies; and pleural effusions [ 5, 11, 20, 21, 27, 28, 30 - 32 ] (Figure 5 ). [ncbi.nlm.nih.gov]
bronchograms; fissural nodularity; ground-glass opacities (Figure 4 ); mediastinal adenopathies; and pleural effusions [ 5, 11, 20, 21, 27, 28, 30 – 32 ] (Figure 5 ). [ojrd.biomedcentral.com]
Microbiology
- Human Herpesvirus 8
Antiviral therapy directed against human herpesvirus 8 have shown variable success. 4 Agents such as interleukin 12 and a variety of angiogenesis inhibitors are under investigation as potential therapies. [ncbi.nlm.nih.gov]
KS is the result of infection with a herpesvirus known as Kaposi sarcoma-associated herpesvirus (KSHV), or human herpesvirus 8 (HHV8). It is in the same family as the Epstein-Barr virus, which causes mononucleosis. [medlineplus.gov]
Human herpesvirus 8 and other cofactors (eg, cytokine-induced growth factors) play an important role in the development of the disease. [ectrx.org]
Definition / general Vascular neoplasm caused by human herpesvirus 8 (HHV8) Tends to be indolent but may be locally aggressive Essential features Etiologic agent of all forms and cases is human herpesvirus 8 (HHV8), HHV8 immunostain will distinguish it [pathologyoutlines.com]
Kaposi's sarcoma is caused by a virus called the human herpesvirus 8 (HHV-8), also known as the Kaposi's sarcoma-associated herpesvirus (KSHV). [nhs.uk]
Pleura
- Pleural Effusion
[…] nodularity, and pleural effusion. [ajronline.org]
Pleural effusion was noted in eight of 22 cases in the literature and in three of the nine cases in the current series. [ncbi.nlm.nih.gov]
Definition / general Usually associated with AIDS, HHV8 infection; also immunocompromise, organ transplant Diffuse reticulonodular pulmonary infiltrates, solitary lung nodules, or pleural effusions Tumor follows lymphatic channels Detection of HHV8 DNA [pathologyoutlines.com]
Pleural effusion was seen in 52% of cases, while 3 patients had plaque thickening of visceral pleura; mediastinal adenopathy was found in 8.6% of cases. Endoscopy detected 14 tracheobronchial Kaposi's lesions. [moh-it.pure.elsevier.com]
Treatment
About this Kaposi’s Treatment Information The following is a general overview of treatment for Kaposi’s sarcoma. Treatment may consist of surgery, chemotherapy, or a combination of these treatment techniques. [texasoncology.com]
Treatment Options for Kaposi Sarcoma For information about the treatments listed below, see the Treatment Option Overview section. [cancer.gov]
Trials are often designed to treat a certain stage of cancer, either as the first form of treatment offered, or as an option for treatment after other treatments have failed to work. [oncolink.org]
In some treatment centres, it has become the treatment of choice for KS. [cancer.ca]
Response rates are quite high and treatment is well tolerated. Chemotherapy can be used in treatment but there is concern that aggressive treatment might further depress the immune system. [healthcentral.com]
Prognosis
People who take HAART have a better prognosis. [drugs.com]
Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The type of Kaposi sarcoma. [rarecancers.org.au]
The KS was controlled with chemotherapy and ongoing HAART. [ 13 ] Prognosis Prognosis depends on the type of KS, status of the patient's immune system, presence of dissemination and whether this is the first appearance of KS or a recurrence. [patient.info]
Patients with only skin involvement, higher CD4 and who are free of HIV-related symptoms have better prognosis. [info.gov.hk]
Depending on the progression of pulmonary Kaposi sarcoma and considering other complications related to AIDS, prognosis for survival of pulmonary Kaposi sarcoma can vary from 4 to 19 months. [disability-benefits-help.org]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
ICD-10-CM Codes › C00-D49 Neoplasms › C45-C49 Malignant neoplasms of mesothelial and soft tissue › Code First Code First Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]
In Lung Cancer, Volume 1: Molecular Pathology Methods and Reviews, leading physicians, scientists, and noted researchers review novel methods for determining the etiology of a variety of lung cancers and present readily reproducible techniques for examining [books.google.com]
Etiology An etiological association with human herpes virus type 8 (HHV8) has been postulated. The AIDS-related and post-transplant variant are associated with immunosuppressive states. [radiopaedia.org]
Epidemiology
A beneficial compendium for those dealing with pulmonary complications of HIV infection, Human Immunodeficiency Virus and the Lung surveys current knowledge on the epidemiology of HIV infection examines HIV's effects on lung cells in addition to immune [books.google.com]
Epidemiology KS is one of the major complications of AIDS [ 10 ]. [ncbi.nlm.nih.gov]
Kaposi sarcoma-associated herpes virus-associated malignancies: Epidemiology, pathogenesis, and advances in treatment. Semin Oncol. 2015;42(2):223–46. Article | PubMed PDQ Adult Treatment Editorial Board. [acgcasereports.gi.org]
Epidemiology Angiosarcomas are relatively rare. They comprise 1-2% of sarcomas in the surgical database from 1982-present from Memorial Hospital. Like other sarcomas, the risk of recurrence depends on the stage of disease. [curesarcoma.org]
Prevention
Prevention There is no way to prevent the milder forms of Kaposi's sarcoma (classic, African, and immunosuppression-related). The most effective way to avoid developing AIDS-related Kaposi's sarcoma is to prevent the spread of HIV. [drugs.com]
Your doctor will prescribe anti-sickness (anti-emetic) drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist explains to you. It’s easier to prevent sickness than to treat it after it has started. [macmillan.org.uk]
Causes The most likely cause of Kaposi's sarcoma is infection with HHV8 combined with the weakening of defense mechanisms that normally prevent this virus from multiplying. [medbroadcast.com]
How can I prevent Kaposi’s sarcoma? Kaposi sarcoma is caused by the HHV-8 infection. There are no vaccines to protect against it at this point. Preventing the transmission of HHV-8 is the best way to prevent KS. [oncolink.org]
Safer sexual practices can prevent HIV infection. This prevents HIV/AIDS and its complications, including KS. KS almost never occurs in people with HIV/AIDS whose disease is well controlled. Kaposi's sarcoma; HIV - Kaposi; AIDS - Kaposi Habif TP. [medlineplus.gov]