CTICasesMulticentric Castleman Disease and Kaposi Sarcoma
Imaging findings
Chest CT in an HIV-positive patient reveals bulky, multi-station mediastinal and hilar lymphadenopathy. The lung windows demonstrate multiple ill-defined, nodular, and flame-shaped opacities extending along the bronchovascular bundles, consistent with pulmonary Kaposi sarcoma.
Key takeaways
Human herpesvirus 8 (HHV-8) is a key oncogenic virus that drives both multicentric Castleman disease (MCD) and Kaposi sarcoma (KS), which frequently co-occur in HIV-infected individuals. On imaging, the combination of highly vascular, bulky lymphadenopathy (MCD) and flame-shaped bronchovascular nodules (KS) is highly suggestive of co-infection and carries a substantial risk of progression to aggressive large B-cell lymphomas.
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