<prompt> Kaposis sarcoma is associated withHIV infectionAdeno virusPicoma virusAll  <response>: Ans. a HIV infection. Ref. Robbins, Pathology, 7th ed., 256KAPOSIS SARCOMA KS Kaposis sarcoma, a highly vascular tumor is most common neoplasm in AIDS. Other neoplasms found in HIV patients are: B-cell NHL, primary brain lymphoma and invasive carcinoma cervix. HHV-8 or KSHV is strongly implicated as a viral cofactor in the pathogenesis of KS. Cutaneous lesions are the most common. Factor VIII of coagulation cascade is immunohistochemistry marker of KS. Clinically, the initial lesion may be a small, raised reddish-purple nodule on the skin, a discoloration on the oral mucosa, or a swollen lymph node. Lesions often appear in sun-exposed areas, particularly the tip of the nose, and have a propensity to occur in areas of trauma Koebner phenomenon. Some 80 of patients with pulmonary KS have cutaneous lesions, which appear as raised macules. Apart from skin, lymph nodes, gastrointestinal tract, and lungs are the organ systems most commonly affected by KS. Lesions have been reported in virtually every organ, including the heart and the CNS. In contrast to most malignancies, in which lymph node involvement implies metastatic spread and a poor prognosis, lymph node involvement may be seen very early in KS and is of no special clinical significance. CXR characteristically shows bilateral ground-glass haziness, lower lobe infiltrates that obscure the margins of the mediastinum and diaphragm. Pleural effusions are seen in 70 of cases of pulmonary KS, a fact that is often helpful in the differential diagnosis. A diagnosis of KS is based upon biopsy of a suspicious lesion. Histologically one sees a proliferation of spindle cells and endothelial cells, extravasation of red blood cells, hemosiderin-laden macrophages, and, in early cases, an inflammatory cell infiltrate.Management of KS: Spontaneous regressions have been reported in the setting of HAART. Treatment is indicated under two main circumstances. The first is when a single lesion or a limited number of lesions are causing significant discomfort or cosmetic problems, such as with prominent facial lesions, lesions overlying a joint, or lesions in the oropharynx that interfere with swallowing or breathing. Under these circumstances, Rx with localized radiation, intralesional vinblastine, or cryotherapy may be indicated. Note that patients with HIV infection are particularly sensitive to side effects of radiation therapy. The single most important determinant of response appears to be the CD4 T cell count. IFN-alpha provides an added advantage of having antiretroviral activity; thus, it may be the appropriate first choice for single-agent systemic therapy for early patients with disseminated disease. Liposomal daunorubicin, liposomal doxorubicin, and paclitaxel have been approved by the FDA for this indication. Liposomal daunorubicin is approved as first-line therapy for patients with advanced KS. 