PLEURAL AND CUTANEOUS MANIFESTATIONS OF SERONEGATIVE KAPOSI'S SARCOMA IN AN ELDERLY PATIENT: A DIAGNOSTIC CHALLENGE RESOLVED BY THORACOSCOPY

Background: Kaposis sarcoma (KS) is a low-grade vascular tumor etiologically linked to Human Herpesvirus 8 (HHV-8). While heavily documented in HIV-positive individuals (epidemic form), KS can also arise in HIV-negative patients, particularly in elderly Mediterranean or Eastern European men (classic form). Pleural involvement in HIV-negative KS is exceedingly rare, often mimicking tuberculosis or malignant pleural mesothelioma, which frequently leads to diagnostic delays. Case Presentation: We report the case of a 69-year-old male farmer presenting with a one - month history of left - sided pleural pain, progressive dyspnea (mMRC grade II), and profound constitutional symptoms (fatigue, anorexia, significant weight loss). Clinical examination revealed a left pleural effusion syndrome and bilateral, painless lower limb lymphedema associated with purplish skin induration. Laboratory findings highlighted an elevated C-reactive protein (119.40 mg/L) and a negative HIV serology. Thoracic computed tomography and ultrasound revealed a large, multiloculated left pleural effusion with infiltrative pleural masses.