Rapid Progression of Kaposi's sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection: a case report

Abstract

Background: AIDS-related KS generally involves cutaneous lesions, that slowly progress over months to years. Neither rapidly progressing of KS nor KS complicated with hemophagocytic syndrome (HPS) has rarely been reported.

Case presentation: We report a rare case of rapid progression of Kaposi's sarcoma complicated with hemophagocytic syndrome in a severely immunosuppressed patient with HIV-infection. The symptoms of this patient were atypical, showing only persistent high fever and rapid progressed to hemophagocytic syndrome. This patient was successfully treated with antiretroviral therapy combined with liposomal doxorubicin.

Conclusions: The condition of the KS patient could deteriorate rapidly over a period of days and even developeded into HPS, which was life-threatening. However, chemotherapy initiated in a timely manner might improve prognosis.

Keywords: AIDS; Hemophagocytic syndrome; Kaposi's sarcoma.

Fig. 1

The changes in lesions and spleen before and after chemotherapy. The lesions on oral and palmar surfaces increased both in size and number before chemotherapy (a-1, a-2, b-1, b-2), but they faded away after chemotherapy (a-3, a-4, b-3, b-4). The abdominal CT scans showed splenomegaly before chemotherapy (c-1, c-2), but the size of the spleen decreased to normal (c-3, c-4) after chemotherapy

Fig. 2

Pathological findings of the nodular lesion on palate. a Spindle cells in the dermis grew diffusely with the exudation of a large number of parenchyma vessels and red blood cells (hematoxylin and eosin, 40 ×). b Strong and diffuse expression of human herpesvirus-8 was noted (HHV-8 immunostaining, 20 ×)