Lymphangiectatic Kaposi's sarcoma in a patient with\nAIDS
In 2001, a 32-year-old male was referred to the department of dermatology reporting a\nhistory of lesions in the proximal right thigh. A skin biopsy was performed and\nsuggested diagnosis of KS. A partial improvement was noted when antiretroviral therapy\n(TARV) was started, but the patient was lost to follow-up. At diagnosis, CD4+ T-cell\ncount was 409 cells/mm3 and viral load 76,000 copies/mm. In 2010, the patient returned with a worsening clinical status, including an\nincreased number of lesions and edema around the right lower limb. Dermatological\nexamination revealed isolated and confluent erythematousviolaceous tuberous lesions of\nvarying sizes as well as a vegetating tumor on the inner right thigh ( and ). Histopathological examination revealed inter-cellular epidermal edema,\nproliferation of spindle cells, neoangiogenesis and large dilated intratumoral and\nperitumoral thin-walled lymphatic vessels (). Magnetic resonance imaging showed a volumetric increase in the diameter of\nthe entire right thigh associated with severe edema of the entire subcutaneous tissue\nand a heterogeneous, hypodense area in the proximal right thigh (). Lymphangiocintigraphy revealed bilateral retention of the\nradiotracer, which was more pronounced in the right lower limb, with signs of lymphatic\nleakage (). CT scan of the skull and chest\nshowed no abnormalities and the endoscopy was normal. The patient was referred to a\nspecialized cancer treatment center, where he resumed chemotherapy with paclitaxel, with\npartial reduction of edema and lesions.