PULMONARY MANIFESTATIONS OF AIDS NLM AIDSLINE Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.

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PULMONARY MANIFESTATIONS OF AIDS

Radiology of AIDS. Federle MP et al, eds. New York, Raven, p. 47-76, 1988.. Unique Identifier : AIDSLINE ICDB/89655313
Naidich DP; Garay SM; Goodman PC; Rybak BJ; Kramer EL; Bellevue Hosp., New York Univ. Medical Center, 560 First Ave.,; New York, NY 10016

Abstract: More than 50% of patients (pts) with AIDS develop pulmonary manifestations at some time during the course of their disease. Radiographic evaluation plays an important role in the diagnosis and management of these pts, despite considerable overlap in the clinical and radiographic manifestations of these varied pulmonary disorders. Radiographic appearance of the chest and other characteristics are reviewed for the following AIDS-associated diseases: opportunistic infections (Pneumocystis carinii pneumonia, mycobacterial tuberculosis, cytomegalovirus infection, and miscellaneous fungal and bacterial infections), Kaposi's sarcoma, lymphocytic interstitial pneumonitis, AIDS-related lymphoma, rare malignancies associated with AIDS, and cardiac disease in AIDS pts. The following interpretive guidelines are suggested: (1) because no pathognomonic radiographic abnormalities exist, histologic or bacteriologic confirmation must be obtained whenever possible; (2) because opportunistic infection and tumor may be present even with a normal-appearing chest radiograph, symptomatic pts or those with borderline arterial blood gases or diffusion capacity should be evaluated further with a gallium scan; (3) mediastinal or hilar adenopathy always should be interpreted as indicating serious intrathoracic disease; (4) while focal parenchymal disease may be a manifestation of P carinii pneumonia, the increasing incidence of serious bacterial infections in pts with AIDS justifies an aggressive diagnostic approach to identify potentially treatable infections; (5) computerized tomography (CT) may be valuable in cases in which transbronchial or transthoracic biopsy is planned for precise localization or to exclude the presence of parenchymal cysts in high-risk pts; and (6) CT can be used in other ways, such as mapping the extent and precise location of intrathoracic lymph nodes, characterizing otherwise confusing radiographic patterns, or identifying the typical pattern of peribronchial and vascular Kaposi's sarcoma. (103 Refs)
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIOGRAPHY Cytomegalovirus Infections/RADIOGRAPHY Human Lung Diseases/COMPLICATIONS/*RADIOGRAPHY Lung Neoplasms/*RADIOGRAPHY Lymphoma/RADIOGRAPHY Opportunistic Infections/*RADIOGRAPHY Pneumonia, Pneumocystis carinii/RADIOGRAPHY Sarcoma, Kaposi's/RADIOGRAPHY Tomography, X-Ray Computed Tuberculosis, Pulmonary/RADIOGRAPHY MONOGRAPH REVIEW, TUTORIAL REVIEW

KWDacquiredimmunodeficiencysyndrome/complications/KWDradiographycytomegalovirusinfections/radiographyhumanlungdiseases/complications/KWDradiographylungneoplasms/KWDradiographylymphoma/radiographyopportunisticinfections/KWDradiographypneumonia,pneumocystiscarinii/radiographysarcoma,kaposi's/radiographytomography,x-raycomputedtuberculosis,pulmonary/radiographymonographreview,tutorialreview
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M89A0651

Copyright © 1989 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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