Presentation
Fever, cough and hemoptysis for 1 month, worsening over the past few days.
Patient Data
CT scout view demonstrates multiple bilateral irregular nodular and ground glass opacities, predominantly affecting the mid and lower lung zones.
Axial images show multiple bilateral scattered flame shaped irregular lung nodules predominantly in a peribronchovascular distribution. Some are associated with spreading ground glass opacity and interlobular septal thickening in a crazy paving pattern.
Enlarged enhancing mediastinal, hilar and bilateral axillary lymph nodes..
Multiple small hypodense liver lesions in both lobes.
Nodular thickening of the adrenal glands.
Bilateral enhancing inguinal lymph nodes.
Diffuse enhancing subcutaneous nodules.
Case Discussion
The diagnosis was suspected due to the presence of multiple purple skin macules. CT confirms typical features of disseminated Kaposi sarcoma involving the lungs, liver and lymphatic system. Peribronchovascular opacities are accompanied by ground glass opacity due to pulmonary hemorrhage.
Case contributed by Dr. Joe Ghattas Yazbeck and Dr. Jean Aziz Dib.
Case supervised by Dr. Augustin Gaudemer.
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