[Kaposi's sarcoma with pericardial tamponade in AIDS].

In two males with AIDS, aged 26 and 39 years, who had disseminated Kaposi's sarcoma, massive pericardial effusion with tamponade (confirmed by echocardiography) developed in the final stages. Multiple pericardial taps, of up to two litres, of serous fluid yielded no malignant cells or pathogens cytologically or microbiologically. At autopsy the finding was of cytomegalovirus and cryptococcus septicaemia, respectively, and generalized Kaposi's sarcoma with infiltration of the heart along the great vessels and subepicardially along the coronary vessels. The pericardial sac was distended balloon-like with 800 ml sanguinous fluid (in both cases). Histological examination did not demonstrate cytomegalic inclusion bodies or fungal granulomas in cardiac tissue. The pericardial effusion was probably due to tumour spread in the lymph channels and along the vasa vasorum.