Kaposi Sarcoma — RACP Adult Medicine MCQ

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ModerateInfectious DiseasesKaposi SarcomaRACP Adult Medicine

A 50-year-old man with HIV (CD4 200, VL undetectable on ART) presents with multiple violaceous papules and plaques on his lower legs and palate. Biopsy shows vascular proliferation with spindle cells and slit-like vascular spaces. HHV-8 staining is positive. What is the diagnosis?

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Correct answer: D — Angiosarcoma

Violaceous vascular papules/plaques in HIV with HHV-8 positivity and characteristic histology (spindle cell proliferation with slit-like vascular spaces) is diagnostic of Kaposi sarcoma. KS is associated with HHV-8 (human herpesvirus 8) and occurs in HIV patients, transplant recipients, and in endemic (Mediterranean/African) forms. In HIV-associated KS, optimising ART (immune reconstitution) is the primary treatment. For extensive or visceral disease, liposomal doxorubicin is first-line chemotherapy. The palatal lesion indicates mucosal involvement.

Reference: eTG – 2025 – Dermatology; ASHM – 2024 – HIV-Associated Malignancies