We present two unique cases in which two HIV positive patients with generalized lymphadenopathy and pancytopenia without any skin lesions were diagnosed with primary lymph node Kaposi´s Sarcoma after excisional biopsy of an inguinal lymph node. Two men who have sex with men (MSM) patients between 20-23 years old, were admitted to Roosevelt Hospital in Guatemala because of generalized lymphadenopathy and pancytopenia. Excisional biopsy of inguinal lymph nodes was performed on both patients.Histologic evaluation of the surgical specimen revealed spindle-shaped cells with extravasated erythrocytes typical of Kaposi’s sarcoma. After explaining the patients and discussing the cases with the oncology unit, both were treated with Paclitaxel showing reduced lymph nodes and hematological recovery by day 4.