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Case report


Pulmonary Kaposi Sarcoma without Mucocutaneous: Involvement The Role of Sequential Thallium and Gallium Scintigraphy

Peter Nguyen1Adam Knapp-Wachsner1Caleb G. Hsieh2Nader Kamangar2
1Department of Medicine, 2Division of Pulmonary and Critical Care Medicine, Olive View-UCLA Medical Center, Sylmar, California, USA
Date of Submission: 08-Nov-2018, Date of Acceptance: 11-Feb-2019, Date of Web Publication: 30-Apr-2019.
Corresponding Author:
Corresponding Author

Nader Kamangar

Department of Medicine, Division of Pulmonary and Critical Care Medicine, UCLA Geffen School of Medicine, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B-182, Sylmar, California 91342, USA
E-mail: kamangar@ucla.edu

Corresponding Author:
Corresponding Author

Nader Kamangar

Department of Medicine, Division of Pulmonary and Critical Care Medicine, UCLA Geffen School of Medicine, Olive View-UCLA Medical Center, 14445 Olive View Drive, 2B-182, Sylmar, California 91342, USA
E-mail: kamangar@ucla.edu

DOI: 10.25259/JCIS_76_18 Facebook Twitter Google Linkedin

ABSTRACT


Kaposi sarcoma (KS) is a vascular-related tumor that has been associated with human immunodeficiency virus (HIV). It commonly involves the skin and lymph nodes, and infrequently involves the lungs. In very rare instances, pulmonary KS can be found in the absence of endobronchial and mucocutaneous involvement. Utilization of sequential thallium and gallium scintigraphy can aid in the diagnosis of pulmonary KS in the absence of mucocutaneous and endobronchial involvement. In this report, we discuss a case of a patient with acquired immunodeficiency syndrome who presented with dyspnea and cough and was found to have subtle pulmonary parenchymal nodular airspace opacities. He underwent negative infectious evaluation, including bronchoscopy. Despite the absence of mucocutaneous findings, sequential positive thallium and negative gallium scintigraphy led to an early diagnosis of pulmonary KS. Pulmonary KS in the absence of mucocutaneous involvement is a rare finding that is exceedingly difficult to diagnose. However, pulmonary KS should be considered in patients with HIV who present with respiratory symptoms even if the typical mucocutaneous manifestations of KS are absent. In such circumstances, sequential thallium and gallium scintigraphy can help differentiate pulmonary KS from other processes such as infections and lymphoma, and assist in establishing an earlier diagnosis.
Keywords: Acquired immunodeficiency syndrome thallium scintigraphy, gallium scintigraphy, human immunodeficiency virus, Kaposi sarcoma

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