Endobronchial Kaposi’s Sarcoma

A 55-year-old man with a history of orthotopic liver transplantation developed post-transplantation Kaposi’s sarcoma, which was previously diagnosed in his liver, ventricle, and lymph nodes. A routine bronchoscopy revealed a darkened patch of endobronchial mucosa in the left lower lobe, leading to suspicion of endobronchial Kaposi’s sarcoma.

Histopathological analysis showed spindle-shaped cells forming vascular structures, which stained positive for human herpesvirus 8, confirming the diagnosis. Despite new pulmonary opacities detected on CT, the patient had no respiratory symptoms. Transbronchial biopsy revealed organizing pneumonia, likely induced by everolimus toxicity, rather than Kaposi’s sarcoma progression. Treatment was continued without modifications, except for tapering the everolimus dose.

Recipients of solid-organ transplants face an elevated risk of Kaposi’s sarcoma due to immunosuppressive therapy. Endobronchial involvement may remain asymptomatic, as seen in this case, or lead to cough or hemoptysis.

A 55-year-old man with a history of orthotopic liver transplantation developed post-transplantation Kaposi’s sarcoma, which was previously diagnosed in his liver, ventricle, and lymph nodes. A routine bronchoscopy revealed a darkened patch of endobronchial mucosa in the left lower lobe, leading to suspicion of endobronchial Kaposi’s sarcoma.

Histopathological analysis showed spindle-shaped cells forming vascular structures, which stained positive for human herpesvirus 8, confirming the diagnosis. Despite new pulmonary opacities detected on CT, the patient had no respiratory symptoms. Transbronchial biopsy revealed organizing pneumonia, likely induced by everolimus toxicity, rather than Kaposi’s sarcoma progression. Treatment was continued without modifications, except for tapering the everolimus dose.

Recipients of solid-organ transplants face an elevated risk of Kaposi’s sarcoma due to immunosuppressive therapy. Endobronchial involvement may remain asymptomatic, as seen in this case, or lead to cough or hemoptysis.