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Case Report Open Access

Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case

  • Authors:
    • Geran Maule
    • Saar Peles
    • Hisham Husham
    • Mohammad Khraisat
    • Abdallah Rayyan
    • Luis Javier
  • View Affiliations / Copyright

    Affiliations: College of Medicine, University of Central Florida, Orlando, FL 32827, USA
    Copyright: © Maule et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 62
    |
    Published online on: August 19, 2025
       https://doi.org/10.3892/mi.2025.261
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Abstract

Pulmonary angiosarcoma is a rare, aggressive malignancy often mimicking other lung cancers. The present study describes the case of a 36‑year‑old male patient with human immunodeficiency virus (HIV) on highly active antiretroviral therapy who developed severe hemoptysis and respiratory distress, initially attributing his symptoms to mold exposure. Imaging revealed bilateral pulmonary nodules surrounded by ground‑glass (suggestive of hemorrhagic lesions), and a biopsy confirmed stage IV pulmonary angiosarcoma. Immunohistochemical staining yielded positive results for ERG, CD31, CD34 and CD117, and echocardiography identified a large tricuspid valve mass, suggesting metastatic disease. He was commenced on paclitaxel treatment, but switched to doxorubicin following an infusion reaction. His course was complicated by recurrent hemothorax and pericardial effusions, requiring thoracentesis, chest tube placement and pericardiocentesis. Due to disease progression and frequent readmissions, he ultimately opted for hospice care. The case described herein illustrates the diagnostic complexity of pulmonary angiosarcoma in the setting of HIV and highlights the poor prognosis associated with extensive pulmonary and cardiac involvement.
View Figures

Figure 1

Chest computed tomography scan (day
1), illustrating bilateral pulmonary nodules with surrounding
ground-glass halos, largest measuring 29x24 mm in the left lower
lobe (red arrow).

Figure 2

Chest computed tomography scan (day
14) illustrating the increased size and number of nodules.
Bilateral pulmonary nodules are indicated by blue arrows, and
pulmonary masses with surrounding ground-glass opacity are
indicated by red arrows.

Figure 3

(A) H&E staining, x200
magnification illustrating poorly differentiated spindle cell
neoplasm with moderate nuclear atypia, hemorrhage, and red blood
cell extravasation; (B) CD34 stain, x200 magnification, positive;
(C) CD31, x200 magnification, positive.

Figure 4

Coronal (left panel) and axial (right
panel) non-contrast chest computed tomography scan (day 45)
illustrating large left pleural effusion with near-complete lung
collapse.

Figure 5

Non-contrast chest computed tomography
scan (day 70) illustrating an improvement in the size and number of
nodules following doxorubicin treatment.

Figure 6

Axial (left panel) and sagittal (right
panel) non-contrast head computed tomography scan (day 106)
illustrating an 8-mm right frontal hemorrhagic metastasis with
surrounding edema.
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Copy and paste a formatted citation
Spandidos Publications style
Maule G, Peles S, Husham H, Khraisat M, Rayyan A and Javier L: Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case. Med Int 5: 62, 2025.
APA
Maule, G., Peles, S., Husham, H., Khraisat, M., Rayyan, A., & Javier, L. (2025). Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case. Medicine International, 5, 62. https://doi.org/10.3892/mi.2025.261
MLA
Maule, G., Peles, S., Husham, H., Khraisat, M., Rayyan, A., Javier, L."Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case". Medicine International 5.6 (2025): 62.
Chicago
Maule, G., Peles, S., Husham, H., Khraisat, M., Rayyan, A., Javier, L."Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case". Medicine International 5, no. 6 (2025): 62. https://doi.org/10.3892/mi.2025.261
Copy and paste a formatted citation
x
Spandidos Publications style
Maule G, Peles S, Husham H, Khraisat M, Rayyan A and Javier L: Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case. Med Int 5: 62, 2025.
APA
Maule, G., Peles, S., Husham, H., Khraisat, M., Rayyan, A., & Javier, L. (2025). Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case. Medicine International, 5, 62. https://doi.org/10.3892/mi.2025.261
MLA
Maule, G., Peles, S., Husham, H., Khraisat, M., Rayyan, A., Javier, L."Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case". Medicine International 5.6 (2025): 62.
Chicago
Maule, G., Peles, S., Husham, H., Khraisat, M., Rayyan, A., Javier, L."Pulmonary angiosarcoma in an HIV‑positive patient presenting with hemoptysis and multisystem involvement: Report of a rare case". Medicine International 5, no. 6 (2025): 62. https://doi.org/10.3892/mi.2025.261
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