Pulmonary Kaposi sarcoma in patients with AIDS: Scintigraphic diagnosis with sequential thallium and gallium scanning

Article Abstract:

Kaposi's sarcoma (KS) is a rare disease frequently seen in AIDS patients. It is characterized by tumorous growths seen predominantly in skin tissue, but sometimes also in lymph node and lung tissues. KS affecting skin tissue is easily diagnosed, but when lung tissue is affected, the diagnosis of KS is difficult. Clinical symptoms and chest X-ray results are similar for a number of lung diseases often seen in AIDS patients, including those for KS. Prior research has indicated that KS tumors rapidly take up thallium, a radioactive element. Thallium can be administered to patients and the distribution of the thallium in the various tissues can be photographed with a special scanning device. This study examined if radioactive thallium and gallium scanning could detect lung disease caused by KS. Three AIDS patients with suspected KS lung disease were scanned. A final diagnosis of KS lung disease was confirmed in all three cases by examination of lung tissue specimens. In case 1, X-rays showed lung abnormalities two years after the patient had been successfully treated for a lung infection. Gallium scanning results were negative, but thallium scanning results showed a larger uptake of thallium in the lungs in the areas of the abnormalities. The patient died a few months later and an autopsy revealed KS in the right lung. The locations of the KS tumors found on autopsy were the same as the locations of high thallium uptake seen on the scans. In case 2, the patient had evidence of fluid retention in his lungs. Treatment was able to clear the fluid, but X-rays showed an abnormality in the upper lobe of the right lung. Gallium scanning results were negative, but thallium results showed high uptake in the upper lobe of the lung. In case 3, X-rays showed abnormalities in the lower lobe of the lungs. Thallium uptake in this area was high. The final diagnosis was KS. These limited results indicate that thallium scanning may be useful in diagnosing KS lung disease in AIDS patients. This could lead to earlier, more effective treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Lungs, Lung, Radionuclide imaging, Radioisotope scanning

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Varied appearance of AIDS-related lymphoma in the chest

Article Abstract:

Patients with acquired immunodeficiency syndrome (AIDS) often develop cancers, among them Kaposi sarcoma and neoplasms (abnormal tissue or tumor growth) such as lymphoma (general tissue growth in the lymphatic system). Federal health care authorities recognize lymphoma as a criterion for making a diagnosis of AIDS even when lymphoma in AIDS patients may occur prior to the diagnosis of the disease. Diagnosis of AIDS is usually made when a patient is known to be infected with the human immunodeficiency virus (HIV). AIDS-related lymphoma (ARLs) differs from lymphoma in the general (non-AIDS) population: ARLs are more common, aggressive (faster growing), and more difficult to treat. Thirty-five patients with ARL were evaluated with computed tomography (CT) scanning of the thorax (which includes the chest and abdomen) and brain to assess the spread of ARL. ARLs viewed on CT images were common in the chest, lungs, and abdomen. There was no dominant pattern of ARL involvement in any of these parts of the body. An ARL diagnosis was made by taking a tissue sample (biopsy) from the lung or pleura (the membrane that encloses the lung). The study revealed that an inconsistent pattern of ARL development is typical in ARL. The total population of HIV infected individuals in the US is estimated to be 1.5 million, of whom 2.7 percent have ARL. Physicians treating HIV-infected patients should evaluate either the pleura or lungs for the presence of ARL.

Causes of, Physiological aspects, HIV (Viruses), HIV, Lymphomas, Tumors

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