THE NEW ZEALAND MEDICAL JOURNAL

A 50-year-old man with HIV/AIDS presented with 1 day of haematemesis and melaena. He denied abdominal pain or fever. There was no recent use of non-steroidal anti-inflammatory drugs (NSAIDs). The patient was not taking any anti-retroviral medications. His most recent serum CD4 count was 13 cells per cubic millimetre. The patient underwent oesophagogastroduodenoscopy that demonstrated purple frond-like papillary mounds in the 2nd portion of the duodenum (Figures 1 and 2). Biopsies of these lesions revealed spindle cells arranged in fascicles with slit-like dense and irregular vascular spaces, creating a sieve-like appearance (Figure 3). Staining for Human Herpes Virus 8 was positive (Figure 4). The patient was diagnosed with duodenal Kaposi’s sarcoma. He was restarted on HAART therapy and has had no further episodes of bleeding. Discussion Kaposi sarcoma (KS) is a low grade vascular tumour associated with human herpes simplex virus 8 (HHV-8) infection.1 It is classified into four clinical variants: A. Classic