Pulmonary neoplastic and lymphoproliferative disease in AIDS: a review

Article Abstract:

Neoplastic disease (tumors) frequently occur in patients with acquired immunodeficiency syndrome (AIDS). The two most commonly found neoplastic diseases are Kaposi's sarcoma (KS), a cancer of the skin and other tissues, and lymphoma, cancer of the lymphatic system. KS often invades the lungs and chest of AIDS patients, and lymphoma may also be found. X-ray diagnosis is often difficult because lung infection will mask these diseases. Lung biopsy is required for a definite diagnosis. KS in the lungs may be localized, but is usually diffuse (widespread), which inhibits diagnosis because it can be confused with lung infections when viewed on an X-ray. There are clues that can help to diagnose it, for example KS is usually found in other parts of the body if it is affecting the lungs, and pleural fluid will often be found, with spitting of blood from the lungs (hemoptysis). Lymphoma is not as commonly found in the lungs of AIDS patients. The lymphomas that are seen are predominately of the high-grade (aggressive) type. Lymphadenopathy (disease and swelling of the lymph nodes) is seen in the thoracic (chest) regions as well as most other regions in the AIDS patient. When found in the thoracic region, it is often indicative of mycobacterial infections. Lymphoid interstitial pneumonia is a rare pneumonia of unknown cause. It is increasingly being found in AIDS patients, and is highly indicative of AIDS when found in children. Other types of lung diseases are increasingly being reported. The indications are that a number of such diseases will increasingly be seen in the future because of AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, AIDS (Disease), Kaposi's sarcoma, Lymphatic diseases, Lymphadenopathy

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Parasternal sonography of the internal mammary vessels: technique, normal anatomy, and lymphadenopathy

Article Abstract:

Cancer in the internal mammary lymph node chain occurs in up to 20 percent of patients with operable breast cancer. Recently, ultrasound (US) with a high frequency sector transducer has been used to localize the internal mammary artery and vein and to identify cancer in the lymph nodes of the breast. US exams of breasts that exhibit this type of cancer demonstrate enlarged lymph nodes, which can be confirmed with computed tomography findings as well. On US exams, all nodes appeared as discrete spherical or ovoid masses that give off few ultrasound waves. In a longitudinal scan plane, the enlarged nodes were always separated from the normal internal mammary vessels. In the patient with lymphocytic lymphoma, or cancerous lymph nodes, the enlarged nodes were notably hypoechoic and appeared as matted, continuous masses that extended deep to the costal cartilage. Although parasternal US is a technically simple and quick exam, it does have limitations. For example, anomalies of the costosternal skeleton may hinder palpation of the skeletal landmarks and transducer placement. In addition, marked obesity could prevent adequate sound penetration of the anterior chest wall. The most important limitation is that lymphatic metastasis unassociated with nodal enlargement will probably escape detection with US. The technique merits further investigation through broader clinical trials.

Cancer, Breast, Cancer diagnosis, Mammary ultrasonography

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