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Kaposi sarcoma

Last reviewed: 5 Sep 2023
Last updated: 12 Jul 2023



History and exam

Key diagnostic factors

  • age >50 years
  • male sex
  • geographic location: central Africa or the Mediterranean
  • HIV infection
  • human herpesvirus-8 (HHV-8, also known as Kaposi sarcoma-associated herpesvirus [KSHV]) infection
  • immunosuppression
  • skin lesion
  • oral lesion
  • lymphadenopathy
  • lymphedema
More key diagnostic factors

Other diagnostic factors

  • weight loss
  • abdominal pain
  • gastrointestinal (GI) bleeding
  • diarrhea
  • dyspnea
  • hemoptysis
  • chest pain
  • fever
Other diagnostic factors

Risk factors

  • male sex
  • HIV infection
  • immunosuppressive therapy
  • human herpesvirus-8 (HHV-8, also known as Kaposi sarcoma-associated herpesvirus [KSHV]) infection
  • central African ethnicity
  • drug abuse
  • Jewish ethnicity
  • Mediterranean ethnicity
  • age <5 years or >50 years
More risk factors

Diagnostic investigations

1st investigations to order

  • HIV test
  • CBC and comprehensive metabolic panel
  • skin/mucosal biopsy
More 1st investigations to order

Investigations to consider

  • chest x-ray
  • chest CT and bronchoscopy
  • CT abdomen/pelvis
  • MRI
  • fecal occult blood
  • gastrointestinal (GI) endoscopy
  • PET scan
  • lymph node biopsy
  • renal function tests
  • liver function tests
More investigations to consider

Emerging tests

  • human herpesvirus-8 (HHV-8) viremia and serology

Treatment algorithm


epidemic (AIDS-related) KS

classic (sporadic) KS

iatrogenic (transplant-related) KS

endemic (observed in sub-Saharan Africa) KS



David Aboulafia, MD

Attending Hematologist and Oncologist

Virginia Mason Clinical Professor of Medicine

Division of Hematology and Oncology

University of Washington




DA is the author of articles cited in this topic.


Dr David Aboulafia would like to gratefully acknowledge Dr Liron Pantanowitz and Dr Bruce J. Dezube, previous contributors to this topic.

Peer reviewers

Justin Stebbing, MA, MRCP, MRCPath, PhD

Consultant Medical Oncologist/Senior Lecturer

Department of Medical Oncology

Imperial College/Imperial Healthcare NHS Trust

Charing Cross Hospital




JS declares that he has no competing interests.

Thierry Simonart, MD, PhD


Department of Dermatology

Erasme University Hospital




TS declares that he has no competing interests.

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  • Guidelines

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