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M94A3021.TXT
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Document 3021
DOCN M94A3021
TI Presentation of pulmonary Kaposi sarcoma.
DT 9412
AU Huang L; Schnapp LM; Goodman PC; Hopewell PC; Stansell JD; San Francisco
General Hospital, University of California, 94110.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):171 (abstract no. PB0110). Unique
Identifier : AIDSLINE ICA10/94369554
AB OBJECTIVE: Describe the clinical characteristics and presentation of
pulmonary Kaposi sarcoma (KS). METHODS: Retrospective chart review of
pulmonary KS cases diagnosed by bronchoscopy at San Francisco General
Hospital from 1985-1993. RESULTS: During the 9 year review period, 200
cases of pulmonary KS were diagnosed at San Francisco General Hospital.
Ninety-one medical records were available for review. All individuals
were HIV-infected males and 70% were caucasian. Risk factors for HIV
were: homosexual/bisexual (71%), homosexual/bisexual and intravenous
drug use (22%), heterosexual contact (3%), intravenous drug use (2%),
and unknown (1%). KS was the AIDS-defining diagnosis in 60%. At
presentation, the known extent of KS was: cutaneous and oropharyngeal
(53%), cutaneous alone (27%), oropharyngeal alone (3%), and GI alone
(1%). Symptoms included: cough (90%), dyspnea (84%), fever (65%), and
hemoptysis (24%). Mean laboratory values were: CD4 count = 54 mm3,
alveolar-arterial difference = 59 mm Hg, white blood cell count = 4.5
K/microL, and serum lactate dehydrogenase = 299 IU/L. Chest radiograph
findings included: interstitial infiltrates (86%), pleural effusions
(54%), nodules (36%), and adenopathy (21%). At bronchoscopy, 50% had
diffuse endobronchial KS lesions. Co-existent pulmonary infections
included: PCP (22%), tuberculosis (2%), and cryptococcus (2%). Fourteen
patients (15%, 95% CI 8%-22%) had pulmonary KS without evidence of
mucocutaneous disease. Of these, 5 had diffuse and 9 had limited
pulmonary KS. PCP was present in 2 of the 5 cases with diffuse and 6 of
the 9 cases with limited pulmonary KS. DISCUSSION: This is the largest
reported series of pulmonary KS. This review represents a selected
population of patients who underwent bronchoscopy for respiratory
symptoms and abnormal chest radiographs. In previous reports, the
incidence of isolated pulmonary KS ranged from 5-7%. In our series,
isolated pulmonary KS was present in 14 of the 91 patients (15%). Eight
of these 14 were diagnosed with concomitant PCP as a cause of their
presentation.
DE Acquired Immunodeficiency Syndrome/*DIAGNOSIS AIDS-Related
Opportunistic Infections/DIAGNOSIS Bisexuality Bronchoscopy
Diagnosis, Differential Female Homosexuality Human Lung
Neoplasms/*DIAGNOSIS Male Neoplasms, Multiple Primary/DIAGNOSIS
Retrospective Studies Risk Factors Sarcoma, Kaposi's/*DIAGNOSIS
Substance Abuse, Intravenous/COMPLICATIONS MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).