Pulmonary Carcinoma in a Patient with HIV Infection
Pulmonary carcinoma (PC) is a rare entity in patients infected with human immunodeficiency virus (HIV-l), its prevalence in our population is 0.19% -0.55% (1.2). In this series does not show an increase in the incidence of CP in HIV positive patients in recent years, despite a significantly prolonged survival. The Italian Cooperative Group on AIDS and cancer has been reported only 19 cases (3) and in the reviewed literature is collected about 150 patients with positive serology for HIV and CP (4). Regardless of the geographic area and manner of acquisition of infection, the most common histological type is adenocarcinoma, the vast majority of patients are smokers and are generally more than 200 CD4 cells at the time of diagnosis.
Following a query by the MEDLINE literature we have not found any case of giant cell CP in subjects with HIV-1.
Male 50 years old. Hemophilia A. Known as HIV + since 1984. He denied using intravenous drugs. Active smoker of 70 pack-years. Since 1989 he suffered frequent hemoptysis income low to moderate amounts, after extensive studies (which included the performance of CT and bronchoscopy on several occasions) were attributed in the left upper lobe bronchiectasis. In August 1995, was admitted for pneumococcal pneumonia.
Before surgery she was given high doses of factor VIII and was ruled out the presence of anti-factor VIII. However, after surgery showed a massive intrathoracic haemorrhage and died at 18 hours of operation.
The giant cell lung carcinoma (PACGS) is a variant of large cell lung carcinoma accounting for 4% of all PC in the general population. PACGS histologically characterized by the presence (at a rate above 30%) of pleomorphic cells and multinucleated giant very undifferentiated (5). Usually associated with smoking. The clinical manifestations are latent and when symptoms most often given is that it is in the form of hemoptysis and cough. It is a fast growing tumor, often seated in the upper lobe of right lung, peripheral location and tendency to invade the chest wall. At the time of diagnosis are shown one or more pulmonary masses, usually of large size and advanced stage, which worsens the prognosis (5,6).