CT APPEARANCES OF INTRATHORACIC KAPOSIS-SARCOMA IN PATIENTS WITH AIDS

Although there have been many studies of the plain radiographic appear ances of intrathoracic Kaposi's sarcoma in patients with the acquired immunodeficiency syndrome, the computed tomography (CT) findings are l ess well established. We performed a retrospective review of the thora cic CT findings of 15 patients with tracheobronchial Kaposi's sarcoma diagnosed at bronchoscopy in whom concurrent respiratory infection had been excluded. The commonest CT finding was the presence of ill-defin ed nodules, seen in all patients. In eight patients more than 20 nodul es were seen. Small areas of ground-glass attenuation surrounded one o r more nodules in 11 patients. Bilateral perihilar infiltrates were se en in 14 patients, extending into the pulmonary parenchyma along bronc hovascular bundles. Interlobular septal thickening was seen in 13 pati ents and fissural nodularity in 15 patients. To our knowledge this lat ter finding has not been described before. Discrete areas of ground-gl ass attenuation were seen in six patients. Small bilateral pleural eff usions occurred in six patients; four patients had a pericardial effus ion. Shotty mediastinal lymphadenopathy occurred in six patients, and mediastinal nodes greater than 1 cm were present in four patients. Non e of the patients had CT evidence of chest wall or bone involvement. A lthough none of these findings are specific, the combination of poorly defined nodules, fissural nodularity and a bronchovascular distributi on of perihilar opacities on CT is highly suggestive of pulmonary Kapo si's sarcoma.