DOI: 10.1148/rg.264055129
Imaging Manifestations of Kaposi Sarcoma1
Carlos S. Restrepo, MD,
Santiago Martínez, MD2,
Julio A. Lemos, MD,
Jorge A. Carrillo, MD,
Diego F. Lemos, MD,
Paulina Ojeda, MD and
Prakash Koshy, MD
1 From the Department of Radiology, Louisiana State University Health Sciences Center, New Orleans, La (C.S.R., S.M., J.A.L., D.F.L., P.K.); and the Department of Radiology, Universidad Nacional de Colombia, Hospital Santa Clara, Bogotá, Colombia (J.A.C., P.O.). Presented as an education exhibit at the 2004 RSNA Annual Meeting. Received June 8, 2005; revision requested July 15 and received October 3; accepted October 5. All authors have no financial relationships to disclose.
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Figure 1. Cutaneous AIDS-related KS. Photomicrograph (hematoxylineosin stain) shows numerous clusters of spindle cells with jagged vascular spaces (arrows) within the dermis.
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Figure 2a. Disseminated AIDS-related KS in a 39-year-old man with neck and head compromise. (a) Head CT scan shows left frontal soft-tissue thickening (arrow), a finding that is consistent with cutaneous KS. (b) CT scan obtained inferior to a shows an ill-defined heterogeneous mass at the nasopharynx (white arrows). Note the areas of enhancement within the lesion (black arrows), a characteristic feature of KS. (c) CT scan of the neck exhibits enlarged hyperattenuating lymph nodes (arrows) with diffuse thickening and increased attenuation of the subcutaneous soft tissues, findings that are consistent with swelling due to lymphatic obstruction. Biopsy of the nasopharyngeal mass was performed. (d) Photomicrograph (immunohistochemical staining) shows diffuse positivity for vimentin. The sample was also positive for CD31.
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Figure 2b. Disseminated AIDS-related KS in a 39-year-old man with neck and head compromise. (a) Head CT scan shows left frontal soft-tissue thickening (arrow), a finding that is consistent with cutaneous KS. (b) CT scan obtained inferior to a shows an ill-defined heterogeneous mass at the nasopharynx (white arrows). Note the areas of enhancement within the lesion (black arrows), a characteristic feature of KS. (c) CT scan of the neck exhibits enlarged hyperattenuating lymph nodes (arrows) with diffuse thickening and increased attenuation of the subcutaneous soft tissues, findings that are consistent with swelling due to lymphatic obstruction. Biopsy of the nasopharyngeal mass was performed. (d) Photomicrograph (immunohistochemical staining) shows diffuse positivity for vimentin. The sample was also positive for CD31.
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Figure 2c. Disseminated AIDS-related KS in a 39-year-old man with neck and head compromise. (a) Head CT scan shows left frontal soft-tissue thickening (arrow), a finding that is consistent with cutaneous KS. (b) CT scan obtained inferior to a shows an ill-defined heterogeneous mass at the nasopharynx (white arrows). Note the areas of enhancement within the lesion (black arrows), a characteristic feature of KS. (c) CT scan of the neck exhibits enlarged hyperattenuating lymph nodes (arrows) with diffuse thickening and increased attenuation of the subcutaneous soft tissues, findings that are consistent with swelling due to lymphatic obstruction. Biopsy of the nasopharyngeal mass was performed. (d) Photomicrograph (immunohistochemical staining) shows diffuse positivity for vimentin. The sample was also positive for CD31.
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Figure 2d. Disseminated AIDS-related KS in a 39-year-old man with neck and head compromise. (a) Head CT scan shows left frontal soft-tissue thickening (arrow), a finding that is consistent with cutaneous KS. (b) CT scan obtained inferior to a shows an ill-defined heterogeneous mass at the nasopharynx (white arrows). Note the areas of enhancement within the lesion (black arrows), a characteristic feature of KS. (c) CT scan of the neck exhibits enlarged hyperattenuating lymph nodes (arrows) with diffuse thickening and increased attenuation of the subcutaneous soft tissues, findings that are consistent with swelling due to lymphatic obstruction. Biopsy of the nasopharyngeal mass was performed. (d) Photomicrograph (immunohistochemical staining) shows diffuse positivity for vimentin. The sample was also positive for CD31.
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Figure 3a. Disseminated AIDS-related KS in a 36-year-old man. (a) Photograph shows nodular violaceous involvement of the tongue base and soft and hard palates. (b) CT scan shows nodularity of the right lingual tonsil and vallecula, partial obliteration of the right pyriform sinus (black arrows), a pedunculated mass arising in the right lateral aspect of the epiglottis (white arrow), and enhancing lymph nodes (*). (c) Contrast-enhanced fat-saturated T1-weighted MR image shows the intensely enhanced mass (arrows).
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Figure 3b. Disseminated AIDS-related KS in a 36-year-old man. (a) Photograph shows nodular violaceous involvement of the tongue base and soft and hard palates. (b) CT scan shows nodularity of the right lingual tonsil and vallecula, partial obliteration of the right pyriform sinus (black arrows), a pedunculated mass arising in the right lateral aspect of the epiglottis (white arrow), and enhancing lymph nodes (*). (c) Contrast-enhanced fat-saturated T1-weighted MR image shows the intensely enhanced mass (arrows).
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Figure 3c. Disseminated AIDS-related KS in a 36-year-old man. (a) Photograph shows nodular violaceous involvement of the tongue base and soft and hard palates. (b) CT scan shows nodularity of the right lingual tonsil and vallecula, partial obliteration of the right pyriform sinus (black arrows), a pedunculated mass arising in the right lateral aspect of the epiglottis (white arrow), and enhancing lymph nodes (*). (c) Contrast-enhanced fat-saturated T1-weighted MR image shows the intensely enhanced mass (arrows).
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Figure 4. Pulmonary KS. Photograph shows pulmonary KS. Arrows indicate violaceous patchy areas in the lungs that correspond to tumor.
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Figure 5. Tracheal KS. Photograph of a tracheal specimen shows KS. Violaceous patches (arrows) along the trachea correspond to tumor. Note also the adenopathies with caseous necrotic tissue (*) due to concomitant tuberculous infection.
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Figure 6. Tracheal AIDS-related KS. Photograph of a tracheal specimen shows violaceous thickening of the tracheal wall and irregularity of its endothelial surface. Histopathologic analysis helped confirm AIDS-related KS.
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Figure 7. Pleural KS. Photograph shows pleural KS, with violaceous patchy areas (arrows) on the pleural surface that correspond to tumor.
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Figure 8a. Pulmonary KS in a 45-year-old man. (a) Chest radiograph shows multiple bilateral ill-defined nodules (arrowheads indicate nodules on the right side). Two indistinct masses (arrows) are identified in the left hemithorax. (b) High-resolution lung CT scan demonstrates two irregular flame-shaped nodules (white arrows) in the right apex and an ill-defined mass (black arrows) in the left apex. The diagnosis was confirmed with fine-needle aspiration biopsy of the left upper lobe mass.
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Figure 8b. Pulmonary KS in a 45-year-old man. (a) Chest radiograph shows multiple bilateral ill-defined nodules (arrowheads indicate nodules on the right side). Two indistinct masses (arrows) are identified in the left hemithorax. (b) High-resolution lung CT scan demonstrates two irregular flame-shaped nodules (white arrows) in the right apex and an ill-defined mass (black arrows) in the left apex. The diagnosis was confirmed with fine-needle aspiration biopsy of the left upper lobe mass.
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Figure 9a. Thoracic AIDS-related KS in a 45-year-old man. (a) Chest radiograph demonstrates multiple bilateral 3–5-mm micronodules in a peribronchovascular distribution. (b) High-resolution lung CT scan shows innumerable bilateral, poorly defined peribronchovascular micronodules, some of which exhibit coalescence. (c) CT scan (soft-tissue windowing) depicts enlarged lymph nodes in the axillae and mediastinum (thin arrows). Note also the bilateral pleural fluid collections as well as some nodularity (thick arrows). Skin compromise is also identified in the left hemithorax (arrowhead). Histopathologic findings were consistent with KS.
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Figure 9b. Thoracic AIDS-related KS in a 45-year-old man. (a) Chest radiograph demonstrates multiple bilateral 3–5-mm micronodules in a peribronchovascular distribution. (b) High-resolution lung CT scan shows innumerable bilateral, poorly defined peribronchovascular micronodules, some of which exhibit coalescence. (c) CT scan (soft-tissue windowing) depicts enlarged lymph nodes in the axillae and mediastinum (thin arrows). Note also the bilateral pleural fluid collections as well as some nodularity (thick arrows). Skin compromise is also identified in the left hemithorax (arrowhead). Histopathologic findings were consistent with KS.
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Figure 9c. Thoracic AIDS-related KS in a 45-year-old man. (a) Chest radiograph demonstrates multiple bilateral 3–5-mm micronodules in a peribronchovascular distribution. (b) High-resolution lung CT scan shows innumerable bilateral, poorly defined peribronchovascular micronodules, some of which exhibit coalescence. (c) CT scan (soft-tissue windowing) depicts enlarged lymph nodes in the axillae and mediastinum (thin arrows). Note also the bilateral pleural fluid collections as well as some nodularity (thick arrows). Skin compromise is also identified in the left hemithorax (arrowhead). Histopathologic findings were consistent with KS.
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Figure 10a. Disseminated AIDS-related KS in a 36-year-old man with thoracic involvement. (a) Chest radiograph shows ill-defined nodular confluent opacities in the left upper lobe. (b) Chest CT scan demonstrates multiple nodules around the bronchus for the apicoposterior segment of the left upper lobe (black arrow). Other small nodules are also identified in the posterior segment of the right upper lobe (white arrows). (c) CT scan (soft-tissue windowing) demonstrates enlarged enhancing lymph nodes (arrows) in the left hilum and occupying the azygoesophageal recess. Bronchoalveolar lavage was negative. Results of transbronchial biopsy confirmed the diagnosis.
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Figure 10b. Disseminated AIDS-related KS in a 36-year-old man with thoracic involvement. (a) Chest radiograph shows ill-defined nodular confluent opacities in the left upper lobe. (b) Chest CT scan demonstrates multiple nodules around the bronchus for the apicoposterior segment of the left upper lobe (black arrow). Other small nodules are also identified in the posterior segment of the right upper lobe (white arrows). (c) CT scan (soft-tissue windowing) demonstrates enlarged enhancing lymph nodes (arrows) in the left hilum and occupying the azygoesophageal recess. Bronchoalveolar lavage was negative. Results of transbronchial biopsy confirmed the diagnosis.
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Figure 10c. Disseminated AIDS-related KS in a 36-year-old man with thoracic involvement. (a) Chest radiograph shows ill-defined nodular confluent opacities in the left upper lobe. (b) Chest CT scan demonstrates multiple nodules around the bronchus for the apicoposterior segment of the left upper lobe (black arrow). Other small nodules are also identified in the posterior segment of the right upper lobe (white arrows). (c) CT scan (soft-tissue windowing) demonstrates enlarged enhancing lymph nodes (arrows) in the left hilum and occupying the azygoesophageal recess. Bronchoalveolar lavage was negative. Results of transbronchial biopsy confirmed the diagnosis.
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Figure 11. KS in a 40-year-old man with AIDS who presented with weight loss and fever. Abdominal CT scan shows a pleural mass (black arrow) with soft-tissue enhancement in the left pleural space associated with bilateral pleural fluid (white arrows). Imaging-guided biopsy revealed KS. (Courtesy of Diego Aguirre, MD, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.)
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Figure 12a. Cutaneous AIDS-related KS in a 39-year-old man with a history of fever and productive cough. (a) Chest radiograph shows consolidation of the middle lobe, a finding that is consistent with lobar pneumonia. Bronchoalveolar lavage performed at this time was negative. Despite undergoing antibiotic treatment, the patient developed shortness of breath and acute anemia with diffuse bilateral opacities at chest radiography and died. (b) Photograph of the gross specimen of the lungs shows bilateral alveolar hemorrhage with multiple foci of KS, particularly in the middle lobe (arrows).
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Figure 12b. Cutaneous AIDS-related KS in a 39-year-old man with a history of fever and productive cough. (a) Chest radiograph shows consolidation of the middle lobe, a finding that is consistent with lobar pneumonia. Bronchoalveolar lavage performed at this time was negative. Despite undergoing antibiotic treatment, the patient developed shortness of breath and acute anemia with diffuse bilateral opacities at chest radiography and died. (b) Photograph of the gross specimen of the lungs shows bilateral alveolar hemorrhage with multiple foci of KS, particularly in the middle lobe (arrows).
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Figure 13a. Pulmonary AIDS-related KS in a 35-year-old man with a history of resolved P jiroveci pneumonia. (a) Chest radiograph shows thickening and nodularity of the bronchovascular bundles and cardiomegaly. (b) High-resolution chest CT scan demonstrates bilateral cavitated flame-shaped nodules. Although cavitation has been described in patients with AIDS-related KS, most cases seem to be related to concomitant P jiroveci infection. In this case, the diagnosis of KS was histopathologically confirmed. There was no evidence of P jiroveci pneumonia.
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Figure 13b. Pulmonary AIDS-related KS in a 35-year-old man with a history of resolved P jiroveci pneumonia. (a) Chest radiograph shows thickening and nodularity of the bronchovascular bundles and cardiomegaly. (b) High-resolution chest CT scan demonstrates bilateral cavitated flame-shaped nodules. Although cavitation has been described in patients with AIDS-related KS, most cases seem to be related to concomitant P jiroveci infection. In this case, the diagnosis of KS was histopathologically confirmed. There was no evidence of P jiroveci pneumonia.
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Figure 14. KS in a 45-year-old HIV-positive man who presented with weight loss and fever. Sagittal US image through the right upper quadrant shows abnormal heterogeneous echogenicity of the liver, with multiple nodular hyperechoic lesions throughout the liver parenchyma. Open biopsy demonstrated KS. (Courtesy of Diego Aguirre, MD, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.)
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Figure 15a. Disseminated AIDS-related KS in a 37-year-old man with abdominal compromise. (a) Abdominal CT scan shows ill-defined peripheral portal liver nodules (arrows). Some of the nodules show hypoattenuation, whereas others show enhancement. (b) CT scan obtained inferior to a shows multiple retrocaval, interaortocaval, and paraaortic hyperattenuating adenopathies (*). a = aorta, c = inferior vena cava. (c) CT scan obtained at the inguinal level shows multiple enlarged, enhancing lymph nodes (*). Note also the diffuse subcutaneous soft-tissue swelling, a finding that is consistent with lymphatic obstruction. Results of liver and lymph node inguinal biopsies confirmed KS.
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Figure 15b. Disseminated AIDS-related KS in a 37-year-old man with abdominal compromise. (a) Abdominal CT scan shows ill-defined peripheral portal liver nodules (arrows). Some of the nodules show hypoattenuation, whereas others show enhancement. (b) CT scan obtained inferior to a shows multiple retrocaval, interaortocaval, and paraaortic hyperattenuating adenopathies (*). a = aorta, c = inferior vena cava. (c) CT scan obtained at the inguinal level shows multiple enlarged, enhancing lymph nodes (*). Note also the diffuse subcutaneous soft-tissue swelling, a finding that is consistent with lymphatic obstruction. Results of liver and lymph node inguinal biopsies confirmed KS.
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Figure 15c. Disseminated AIDS-related KS in a 37-year-old man with abdominal compromise. (a) Abdominal CT scan shows ill-defined peripheral portal liver nodules (arrows). Some of the nodules show hypoattenuation, whereas others show enhancement. (b) CT scan obtained inferior to a shows multiple retrocaval, interaortocaval, and paraaortic hyperattenuating adenopathies (*). a = aorta, c = inferior vena cava. (c) CT scan obtained at the inguinal level shows multiple enlarged, enhancing lymph nodes (*). Note also the diffuse subcutaneous soft-tissue swelling, a finding that is consistent with lymphatic obstruction. Results of liver and lymph node inguinal biopsies confirmed KS.
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Figure 16a. Disseminated AIDS-related KS in a 41-year-old man with abdominal compromise. (a) Arterial phase abdominal CT scan shows an ill-defined, wedge-shaped hypoattenuating lesion (arrow) in the spleen. Note also the enhancing adenopathies in the minor curvature of the stomach. (b) On an equilibrium phase CT scan, the splenic lesion has become isoattenuating, a pattern that is sometimes seen in hemangiomas. Biopsy showed KS.
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Figure 16b. Disseminated AIDS-related KS in a 41-year-old man with abdominal compromise. (a) Arterial phase abdominal CT scan shows an ill-defined, wedge-shaped hypoattenuating lesion (arrow) in the spleen. Note also the enhancing adenopathies in the minor curvature of the stomach. (b) On an equilibrium phase CT scan, the splenic lesion has become isoattenuating, a pattern that is sometimes seen in hemangiomas. Biopsy showed KS.
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Figure 17. Splenic KS in a 50-year-old HIV-positive man. Abdominal CT scan shows multiple subcentimeter hypoattenuating nodules in the spleen. Imaging-guided cytologic analysis revealed KS. (Courtesy of Diego Aguirre, MD, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.)
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Figure 18. KS in a 44-year-old man with AIDS who presented with fever and diarrhea. Abdominal CT scan shows circumferential wall thickening of the cecum (arrows) that is not associated with enlarged lymph nodes or adjacent fat stranding. A flat lesion was visualized at colonoscopy. Subsequent biopsy helped confirm KS. (Courtesy of Diego Aguirre, MD, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.)
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Figure 19. Disseminated AIDS-related KS in a 36-year-old man with rectal compromise. Abdominal CT scan shows a thickened, hypervascular rectal wall (arrows) with involvement of surrounding structures, including the prostate gland. The diagnosis was confirmed with endoscopic biopsy.
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Figure 20. Disseminated AIDS-related KS in a 39-year-old man. Contrast-enhanced abdominal CT scan demonstrates a hyperattenuating soft-tissue nodule eroding the posterior aspect of two ribs (arrows). Note also the other similar subcutaneous nodules (arrowheads), a finding that is consistent with KS.
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Figure 21a. KS in a 42-year-old man with AIDS who presented with a painful soft-tissue mass of the left hip. (a) Pelvic CT scan shows a low-attenuation soft-tissue mass expanding the gluteal muscles and extending to the thigh. (b) Coronal positron emission tomographic scan shows fluorine 18 fluorodeoxyglucose uptake in the gluteal mass. Imaging-guided biopsy revealed KS. (Courtesy of Diego Aguirre, MD, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.)
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Figure 21b. KS in a 42-year-old man with AIDS who presented with a painful soft-tissue mass of the left hip. (a) Pelvic CT scan shows a low-attenuation soft-tissue mass expanding the gluteal muscles and extending to the thigh. (b) Coronal positron emission tomographic scan shows fluorine 18 fluorodeoxyglucose uptake in the gluteal mass. Imaging-guided biopsy revealed KS. (Courtesy of Diego Aguirre, MD, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia.)
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Figure 22a. Disseminated AIDS-related KS in a 35-year-old man with a history of the disease. (a) Abdominal CT scan demonstrates a round, hypoattenuating bone lesion (arrow) in the right aspect of the L1 vertebral body. (b–d) Sagittal MR images of the lumbar spine show the lesion to be isointense with a T1-weighted sequence (b), hyperintense with a T2-weighted sequence (c), and diffusely enhancing with a fat-saturated T1-weighted sequence performed after the intravenous injection of gadopentetate dimeglumine (d). In addition, similar lesions are seen in L2 and L5. Findings at bone biopsy were consistent with KS.
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Figure 22b. Disseminated AIDS-related KS in a 35-year-old man with a history of the disease. (a) Abdominal CT scan demonstrates a round, hypoattenuating bone lesion (arrow) in the right aspect of the L1 vertebral body. (b–d) Sagittal MR images of the lumbar spine show the lesion to be isointense with a T1-weighted sequence (b), hyperintense with a T2-weighted sequence (c), and diffusely enhancing with a fat-saturated T1-weighted sequence performed after the intravenous injection of gadopentetate dimeglumine (d). In addition, similar lesions are seen in L2 and L5. Findings at bone biopsy were consistent with KS.
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Figure 22c. Disseminated AIDS-related KS in a 35-year-old man with a history of the disease. (a) Abdominal CT scan demonstrates a round, hypoattenuating bone lesion (arrow) in the right aspect of the L1 vertebral body. (b–d) Sagittal MR images of the lumbar spine show the lesion to be isointense with a T1-weighted sequence (b), hyperintense with a T2-weighted sequence (c), and diffusely enhancing with a fat-saturated T1-weighted sequence performed after the intravenous injection of gadopentetate dimeglumine (d). In addition, similar lesions are seen in L2 and L5. Findings at bone biopsy were consistent with KS.
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Figure 22d. Disseminated AIDS-related KS in a 35-year-old man with a history of the disease. (a) Abdominal CT scan demonstrates a round, hypoattenuating bone lesion (arrow) in the right aspect of the L1 vertebral body. (b–d) Sagittal MR images of the lumbar spine show the lesion to be isointense with a T1-weighted sequence (b), hyperintense with a T2-weighted sequence (c), and diffusely enhancing with a fat-saturated T1-weighted sequence performed after the intravenous injection of gadopentetate dimeglumine (d). In addition, similar lesions are seen in L2 and L5. Findings at bone biopsy were consistent with KS.
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Figure 23a. Disseminated AIDS-related KS in a 41-year-old man with chronic back pain. (a) Abdominal CT scan demonstrates an ill-defined, hypoattenuating osseous lesion (arrow) in the posterior aspect of the right iliac bone. The lesion was barely visible at T1-weighted MR imaging. (b) MR image obtained after the intravenous administration of gadopentetate dimeglumine shows areas of intense enhancement (arrows).
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Figure 23b. Disseminated AIDS-related KS in a 41-year-old man with chronic back pain. (a) Abdominal CT scan demonstrates an ill-defined, hypoattenuating osseous lesion (arrow) in the posterior aspect of the right iliac bone. The lesion was barely visible at T1-weighted MR imaging. (b) MR image obtained after the intravenous administration of gadopentetate dimeglumine shows areas of intense enhancement (arrows).
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Figure 24a. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Figure 24b. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Figure 24c. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Figure 24d. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Figure 24e. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Figure 24f. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Figure 24g. Disseminated AIDS-related KS in a 45-year-old man who presented with diffuse swelling of the left lower extremity. The patient had a chronic history of skin and thoracic KS with poor response to chemotherapy. (a, b) Anteroposterior (a) and lateral (b) radiographs show diffuse nodular thickening of soft tissues with multiple areas of osteopenia (arrows in a). (c) Bone scintigrams demonstrate irregular radiotracer uptake in the distal left forefoot. ANT = anteroposterior, LAT = lateral, PLA = posterolateral. (d–f) Sagittal MR images show the distal first metatarsal bone and the proximal and distal phalanges of the great toe. These structures are hypointense on the T1-weighted image (d), are hyperintense on the T2-weighted image (arrows in e), and demonstrate enhancement on the contrast-enhanced image (arrows in f). Abnormalities were also identified in multiple phalanges and metatarsal bones as well as in the cuboid bone. (g) MR image shows diffuse thickening and enhancement of the soft tissues (*) surrounding the metatarsal bones. Histopathologic analysis performed after transmetatarsal amputation showed AIDS-related KS without evidence of osteomyelitis.
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Copyright © 2006 by the Radiological Society of North America.
