Kaposi's sarcoma of lymph node leading to a diagnosis of HIV

We present a unique case in which an otherwise healthy patient was diagnosed with HIV after fine needle aspiration cytology of his enlarged lymph nodes revealed Kaposi's sarcoma. A 23-year-old African American male presented with a slowly enlarging unilateral cervical lymph node of approximately three-months' duration. Histologic evaluation of the surgical specimen revealed spindle-shaped cells with extravasated erythrocytes typical of Kaposi's sarcoma. We discussed the results with the patient and the risk factors for HIV were elucidated. Subsequent testing revealed the patient to be HIV-positive. This article puts forth the patient's presentation, workup, and final diagnosis of Kaposi's sarcoma.