![]() The frequency of pulmonary KS without mucocutaneous involvement in patients with AIDS ranges from 0% to 14% but rarely does pulmonary KS present before the presence of mucocutaneous disease. Postmortem evaluation of patients with AIDS and mucocutaneous KS found lung involvement in 47%–75% of cases. Although a few cases have been reported as isolated visceral manifestations of KS, it is extremely uncommon for visceral involvement to occur without mucocutaneous manifestations. Pulmonary KS can involve the lung parenchyma, pleural space, tracheobronchial tree, and mediastinal and hilar lymph nodes. Pulmonary involvement with KS portends a poor prognosis. The disease usually involves lymph nodes and mucocutaneous tissues but on occasion can also affect visceral organs such as the gastrointestinal tract, lungs, liver, and spleen. It is estimated to have affected 15%–20% of men in that demographic. Kaposi sarcoma (KS) is a highly vascular tumor spread by the human herpesvirus-8 (HHV-8) virus that garnered increased recognition as an acquired immunodeficiency syndrome (AIDS)-defining illness in the 1980s following the human immunodeficiency virus (HIV)/AIDS epidemic. 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. 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. Pulmonary KS in the absence of mucocutaneous involvement is a rare finding that is exceedingly difficult to diagnose. Despite the absence of mucocutaneous findings, sequential positive thallium and negative gallium scintigraphy led to an early diagnosis of pulmonary KS. He underwent negative infectious evaluation, including bronchoscopy. 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. Utilization of sequential thallium and gallium scintigraphy can aid in the diagnosis of pulmonary KS in the absence of mucocutaneous and endobronchial involvement. In very rare instances, pulmonary KS can be found in the absence of endobronchial and mucocutaneous involvement. ![]() ![]() It commonly involves the skin and lymph nodes, and infrequently involves the lungs. Kaposi sarcoma (KS) is a vascular-related tumor that has been associated with human immunodeficiency virus (HIV).
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