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Pulmonary Kaposi’s Sarcoma and Its Complications in the HAART Era: A Contemporary Case-Based Review

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Abstract

The early years of the acquired immunodeficiency syndrome (AIDS) epidemic introduced the global medical community to Kaposi’s sarcoma (KS), a heretofore seldom encountered angiosarcomatous neoplasm associated with human herpesvirus-8. At that time, clinicians treating these KS patients were routinely exposed to the pulmonary manifestations of this malignancy, including characteristic airway lesions, peribronchovascular opacities, and the typically hemorrhagic pleural effusions. They also witnessed uncommon complications of pulmonary KS such as chylous effusions, diffuse alveolar hemorrhage, and immune reconstitution inflammatory syndrome. Since the advent of highly active antiretroviral therapy, the incidence of KS has steadily declined and with that so has clinician familiarity with this disease. Herein, we present four KS cases recently encountered at our institution that illustrate both typical manifestations of pulmonary KS as well as its thoracic complications. The case descriptions are followed by a review of these clinical entities with the aim of restoring awareness among frontline physicians of what is now a rare but not quite extinct AIDS-defining neoplasm.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

BAL:

Bronchoalveolar lavage

CT:

Computed tomography

DAH:

Diffuse alveolar hemorrhage

DKA:

Diabetic ketoacidosis

DNA:

Deoxyribonucleic acid

HAART:

Highly active antiretroviral therapy

HHV-8:

Human herpesvirus-8

HIV:

Human immunodeficiency virus

KS:

Kaposi’s sarcoma

PJP:

Pneumocystis jirovecii pneumonia

WBC:

White blood cell

VL:

Viral load

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Authors and Affiliations

  1. Division of Pulmonary and Critical Care Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, 79-01 Broadway, Box D6-4, Elmhurst, NY, 11373, USA

    Oleg Epelbaum

  2. Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Beth Israel, Icahn School of Medicine at Mount Sinai, 7 Dazian Building, First Avenue at 16 Street, New York, NY, 10003, USA

    Ronaldo Go

  3. Department of Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, 79-01 Broadway, Room A1-16, Elmhurst, NY, 11373, USA

    Geminikumar Patel

  4. Division of Pulmonary, Critical Care and Sleep Medicine, Mount Sinai Hospital, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1232, New York, NY, 10029-6754, USA

    Sidney Braman

Authors
  1. Oleg Epelbaum
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  2. Ronaldo Go
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  3. Geminikumar Patel
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  4. Sidney Braman
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Correspondence to Sidney Braman.

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The authors confirm that there are no known conflicts of interest associated with this publication, and there has been no significant financial support for this work that could have influenced its outcome.

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Epelbaum, O., Go, R., Patel, G. et al. Pulmonary Kaposi’s Sarcoma and Its Complications in the HAART Era: A Contemporary Case-Based Review. Lung 194, 163–169 (2016). https://doi.org/10.1007/s00408-015-9830-7

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  • DOI: https://doi.org/10.1007/s00408-015-9830-7

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