Kaposi’s sarcoma is a vascular tumor caused by human herpesvirus 8 infection, commonly seen in homosexual or bisexual men with HIV as a manifestation of having entered the AIDS stage, and is the most common tumor in patients with AIDS.Decreased CD4 cell counts, and high viral loads are important factors in the comorbidities of Kaposi’s sarcoma. It is possible that the risk of developing Kaposi’s sarcoma is increased during the first six months of initial antiretroviral therapy due to the effects of the immune reconstitution inflammatory response syndrome, but decreases as the duration of therapy increases. Manifestations of Kaposi’s sarcoma Skin lesions of Kaposi’s sarcoma are most commonly found on the patient’s lower extremities, face (especially the nose), oral mucosa, and external genitalia. The lesions are mostly oval in shape, arranged in lines, and may be symmetrically distributed. The lesions are usually painless and itchy and usually do not cause necrosis of the skin surface structures. The color of the lesions depends on the degree of localized vascular enrichment, and may appear pink, red, purple, and brown, and in a few cases a yellow halo may be seen around the lesions. Early lesions are easily misdiagnosed as purpura, hematoma, hemangioma, or nevus. The skin lesions of Kaposi’s sarcoma have typical features, combined with the patient’s length of AIDS disease, CD4 cell count, etc., can often be initially presumed to be diagnosed as Kaposi’s sarcoma, but it is recommended that biopsy of the skin lesions should be performed to confirm the diagnosis when possible. The characteristic pathologic and histologic features of Kaposi’s sarcoma are: proliferation of spindle cells in a swirling pattern with leukocyte infiltration, neovascularization with abnormal proliferation of small vessels. Visceral manifestations of Kaposi’s sarcoma Kaposi’s sarcoma can involve almost all the internal organs of the body, including lymph nodes, liver, heart, pancreas, testes, bone marrow, bone and skeletal muscle, etc. It is a manifestation of advanced Kaposi’s sarcoma. The most common extracutaneous sites are the oral cavity, gastrointestinal tract, and respiratory system. Intraoral lesions manifest mainly as ulcers, bleeding, and pain in the oral cavity, usually because they are detected during stomatologic visits. Involvement of the gastrointestinal tract by Kaposi’s sarcoma usually manifests as weight loss, vomiting, abdominal pain, diarrhea and even intestinal obstruction. Endoscopically, it usually presents as a single or fused distribution of hemorrhagic nodules that can be seen anywhere in the gastrointestinal tract. Lung involvement is common in AIDS-related Kaposi’s sarcoma, and patients may present with shortness of breath, fever, cough, hemoptysis, or chest pain, or they may have no self-reported symptoms and have abnormal findings on routine physical examination. Imaging may show nodular, interstitial and/or alveolar infiltrates, enlarged hilar or/and mediastinal lymph nodes, or only isolated nodules. Treatment of Kaposi’s sarcoma The systemic treatment for Kaposi’s sarcoma is antiretroviral therapy. Systemic chemotherapy is usually used for rapidly progressing Kaposi’s sarcoma. In patients with asymptomatic pulmonary Kaposi’s sarcoma, antiretroviral therapy is usually initiated but not accompanied by chemotherapy. If the pulmonary Kaposi’s sarcoma progresses after initiation of antiretroviral therapy, or if the patient presents with symptomatic pulmonary Kaposi’s sarcoma at the time of presentation, concurrent initiation of antiretroviral therapy and administration of systemic chemotherapy are usually required. In rare cases, localized treatment with KS may be indicated. Early initiation of antiretroviral therapy significantly reduces the risk of Kaposi’s sarcoma in patients with HIV. Therefore, HIV infection must be detected and treated early.