cough

1. What is the diagnosis (did I mention he enjoys unprotected sex with multiple
anonymous partners while at the same time experimenting with mind altering IV
drugs)?
A. PCP
B. CMV
C. Kaposi Sarcoma
D. AIDS related pulmonary lymphoma

2. Your attending thinks it’s either Kaposi Sarcoma or Lymphoma- how can you tell the difference (other than the classic CT findings seen in this case)?
A. Kaposi is Thallium Positive, Gallium Negative, Lymphoma is Thallium Positive
B. Kaposi is Thallium Positive, Gallium Positive, Lymphoma is Thallium Negative
C. Kaposi is Thallium Negative, Gallium Negative, Lymphoma is Thallium Positive
D. They are both negative on Thallium and Gallium… clinical correlation

3. For this disease to occur, the CD4 count must be less than?
A. 400
B. 200
C. 50

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Answer :

1. What is the diagnosis (did I mention he enjoys unprotected sex with multiple anonymous partners while at the same time experimenting with mind altering IV drugs)?
A. PCP
B. CMV
C. Kaposi Sarcoma
D. AIDS related pulmonary lymphoma

2. Your attending thinks it’s either Kaposi Sarcoma or Lymphoma- how can you tell the difference (other than the classic CT findings seen in this case)?
A. Kaposi is Thallium Positive, Gallium Negative, Lymphoma is Thallium Positive
B. Kaposi is Thallium Positive, Gallium Positive, Lymphoma is Thallium Negative
C. Kaposi is Thallium Negative, Gallium Negative, Lymphoma is Thallium Positive
D. They are both negative on Thallium and Gallium… clinical correlation

3. For this disease to occur, the CD4 count must be less than?
A. 400
B. 200
C. 50

Kaposi Sarcoma

Tumor caused by Herpes Virus 8, and commonly seen in AIDS patient

Key Feature :

flame shaped

• This is the most common lung tumor in AIDS
(Lymphoma is number two).
• A CD4 count less than 200 is needed
• The tracheobronchial mucosa and perihilar lung are favored.
• The buzzword is “flame shaped. ”
• A bloody pleural effusion is common (50%).
• Hypervascular lymph nodes (also seen in Castlemans)
• Slow Growth, with asymptomatic patients
(despite lungs looking terrible)
• Nukes correlations:

Kaposi:

Lymphoma :

  • Gallium Negative
  • Thallium Positive
  • Gallium Positive
  • Thallium Positive

The way to remember this is that Thallium works on the Na/K+ pump mimicking K+, it needs a living celt to work. Gallium just works with inflammation and Kaposi is not that inflammatory (why the lungs look worse than the patient feels)

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