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M9550797.TXT
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1995-03-25
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Document 0797
DOCN M9550797
TI Carcinoma of the lung in HIV-positive patients: findings on chest
radiographs and CT scans.
DT 9505
AU White CS; Haramati LB; Elder KH; Karp J; Belani CP; Department of
Radiology, University of Maryland Medical System,; Baltimore, MD 21201.
SO AJR Am J Roentgenol. 1995 Mar;164(3):593-7. Unique Identifier : AIDSLINE
MED/95168069
AB OBJECTIVE. Several recent clinical studies have described an association
between HIV seropositivity and lung cancer. The purpose of this study
was to describe the spectrum of imaging findings in HIV-positive
patients who had proved carcinoma of the lung. In particular, we
attempted to define the role of CT in diagnosing HIV-associated lung
cancer. MATERIALS AND METHODS. The study population consisted of 23
HIV-positive patients from two institutions who had lung cancer
diagnosed between 1989 and 1993. All patients had both chest radiographs
and CT scans. The group included 19 men and four women with a mean age
of 42 years. The diagnosis of lung cancer was confirmed by bronchoscopy
in eight patients, by pleural fluid aspiration or pleural biopsy in
seven, by percutaneous needle biopsy of a lung lesion in three, by
biopsy of an extrathoracic site in four, and by thoracotomy in one. Two
thoracic radiologists retrospectively evaluated the chest radiographs
and CT scans to identify parenchymal masses, lymphadenopathy, pleural
disease, chest wall or mediastinal invasion, and metastatic lesions.
RESULTS. Fifteen (65%) of the 23 patients had a central or peripheral
mass or nodule. Eight (35%) had extensive pleural disease, either as an
isolated finding or in combination with other abnormalities. CT scans
showed the malignant lesion underlying the extensive pleural disease in
all but one case. All patients with extensive pleural disease had
adenocarcinoma. No patient in the study was considered a candidate for
resection on the basis of clinical and radiologic evaluation.
CONCLUSION. Lung cancer in HIV-positive patients manifested most often
on chest radiographs as a central or peripheral mass or nodule.
Extensive pleural disease in the absence of an apparent primary lesion
was the second most common major manifestation. Lung cancer therefore
merits serious consideration in the differential diagnosis of extensive
pleural disease in HIV-positive patients. CT was most useful in
evaluating malignant lesions associated with extensive pleural disease.
DE Adenocarcinoma/COMPLICATIONS/RADIOGRAPHY Adult Carcinoma, Squamous
Cell/COMPLICATIONS/RADIOGRAPHY Female Human HIV
Seropositivity/*COMPLICATIONS Lung/*RADIOGRAPHY Lung
Neoplasms/COMPLICATIONS/*RADIOGRAPHY Male Middle Age Tomography,
X-Ray Computed JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).