       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).

