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Peer-reviewedCC BYCureus

Oral Kaposi Sarcoma With Clinical Features Suggestive of Concurrent Multicentric Castleman Disease in Advanced AIDS.

  • Jamil Qiqieh1
  • Imeelda Altone2
  • Kareem Siada2
  • Sonora Desai1
  • Avery Mendelson1
  1. 1Internal Medicine, Henry Ford Health System, Southfield, USA.
  2. 2Internal Medicine, Michigan State University, Lansing, USA.
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Abstract

Kaposi sarcoma (KS) is an AIDS-defining malignancy associated with advanced HIV infection and human herpesvirus-8 (HHV-8). We report a case of biopsy-proven oral KS in a 31-year-old patient with advanced AIDS and clinical features suggestive of concurrent multicentric Castleman disease (MCD), highlighting the diagnostic complexity of overlapping AIDS-related conditions. We describe the clinical presentation, diagnostic evaluation, imaging findings, histopathologic features, and management of a 31-year-old man with advanced AIDS and antiretroviral nonadherence presenting with constitutional, gastrointestinal, and neurologic symptoms. Laboratory evaluation demonstrated profound immunosuppression, elevated HIV viral load, cytopenias, hepatocellular injury, and markedly elevated inflammatory markers. Physical examination revealed violaceous oral and cutaneous lesions. Infectious evaluation was largely unrevealing, while imaging demonstrated diffuse lymphadenopathy and inflammatory colitis. Histopathologic examination of an oral lesion confirmed KS with HHV-8 positivity. The combination of diffuse lymphadenopathy, systemic inflammation, and cytopenias raised concern for concurrent MCD. The patient was restarted on antiretroviral therapy (ART) and initiated on trimethoprim-sulfamethoxazole for Pneumocystis jirovecii pneumonia prophylaxis, with outpatient oncologic follow-up arranged. This case highlights the diagnostic complexity of advanced HIV infection, in which infectious, inflammatory, and malignant processes may coexist. Tissue diagnosis remains essential for distinguishing overlapping HHV-8-associated diseases and guiding management.

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Cite

BibTeXRIS
BibTeX
@article{qiqieh2026oral,
  title = {{Oral Kaposi Sarcoma With Clinical Features Suggestive of Concurrent Multicentric Castleman Disease in Advanced AIDS.}},
  author = {Jamil Qiqieh and Imeelda Altone and Kareem Siada and Sonora Desai and Avery Mendelson},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.116543},
  url = {https://europepmc.org/article/MED/42899219},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Oral Kaposi Sarcoma With Clinical Features Suggestive of Concurrent Multicentric Castleman Disease in Advanced AIDS.
AU  - Jamil Qiqieh
AU  - Imeelda Altone
AU  - Kareem Siada
AU  - Sonora Desai
AU  - Avery Mendelson
PY  - 2026
DA  - 2026/09/19
JO  - Cureus
DO  - 10.7759/cureus.116543
UR  - https://europepmc.org/article/MED/42899219
AB  - Kaposi sarcoma (KS) is an AIDS-defining malignancy associated with advanced HIV infection and human herpesvirus-8 (HHV-8). We report a case of biopsy-proven oral KS in a 31-year-old patient with advanced AIDS and clinical features suggestive of concurrent multicentric Castleman disease (MCD), highlighting the diagnostic complexity of overlapping AIDS-related conditions. We describe the clinical presentation, diagnostic evaluation, imaging findings, histopathologic features, and management of a 31-year-old man with advanced AIDS and antiretroviral nonadherence presenting with constitutional, gastrointestinal, and neurologic symptoms. Laboratory evaluation demonstrated profound immunosuppression, elevated HIV viral load, cytopenias, hepatocellular injury, and markedly elevated inflammatory markers. Physical examination revealed violaceous oral and cutaneous lesions. Infectious evaluation was largely unrevealing, while imaging demonstrated diffuse lymphadenopathy and inflammatory colitis. Histopathologic examination of an oral lesion confirmed KS with HHV-8 positivity. The combination of diffuse lymphadenopathy, systemic inflammation, and cytopenias raised concern for concurrent MCD. The patient was restarted on antiretroviral therapy (ART) and initiated on trimethoprim-sulfamethoxazole for Pneumocystis jirovecii pneumonia prophylaxis, with outpatient oncologic follow-up arranged. This case highlights the diagnostic complexity of advanced HIV infection, in which infectious, inflammatory, and malignant processes may coexist. Tissue diagnosis remains essential for distinguishing overlapping HHV-8-associated diseases and guiding management.
SN  - 2168-8184
ER  -