TN 6 (12-11)

DI 23022.655 Pulmonary Kaposi Sarcoma

COMPASSIONATE ALLOWANCE INFORMATION
 

PULMONARY KAPOSI SARCOMA

ALTERNATE NAMES

Pulmonary KS; PKS

DESCRIPTION

Kaposi Sarcoma (KS) is a cancerous tumor of the connective tissue involving blood and lymphatic vessels. KS is often associated with AIDS (Acquired Immune Deficiency Syndrome). When KS occurs in the lungs, it is referred to as Pulmonary Kaposi Sarcoma (KS) or Kaposi’s sarcoma with pulmonary involvement. Pulmonary KS grows as sheets of tumor tissue in the peribronchial and perivascular interstitial spaces. Symptoms and signs of pulmonary KS include dyspnea (difficulty breathing), fever, non-productive cough, and hemoptysis (coughing up blood). Complications of pulmonary Kaposi sarcoma include respiratory failure caused by airway obstruction, parenchymal involvement, pleural effusion, or pulmonary edema from lymphangitic obstruction.

DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING

Chest CT and MRI may show findings suggestive of pulmonary KS, but the definitive diagnosis is obtained by bronchoscopy showing characteristic lesions. Transbronchial biopsy or open lung biopsy may be necessary if findings on bronchoscopy are inconclusive.

ICD-9: 176.4

ONSET AND PROGRESSION

Survival for pulmonary KS is variable (between 4 to 19 months) after it is first diagnosed. Related deaths are usually due to upper airway obstruction or parenchymal destruction.

TREATMENT

Chemotherapy in combination with antiretroviral therapy is used to treat pulmonary KS. Radiation therapy has also been used in cases where there is intolerance to chemotherapy. Radiation is also used to treat symptomatic airway obstruction.

SUGGESTED PROGRAMMATIC ASSESSMENT*

Suggested MER for Evaluation:

  • Documentation of HIV infection

  • Clinical description of findings, imaging, pathology report of biopsied tissue, and laboratory studies

Suggested Listings for Evaluation:

DETERMINATION

 LISTING 

REMARKS

Meets Listing

 14.08E2b

114.08E2b

 

Medical Equals

  

* Adjudicators may, at their discretion, use the Medical Evidence of Record or Listings suggested to evaluate the claim. However, the decision to allow or deny the claim rests with the adjudicator.


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0423022655
DI 23022.655 - Pulmonary Kaposi Sarcoma - 12/09/2011
Batch run: 12/09/2011
Rev:12/09/2011