Archive for the ‘Bronchogenic Carcinoma’ Category

The primary lung cancer patients identified in the HIV-AIDS cohort were characterized by early age at diagnosis. The median age at the time of primary lung cancer diagnosis was 49 years. This is in contrast to the general U S population, where the median age at lung cancer diagnosis is 68 years. Most primary lung cancers were identified in young white (66.7%) and African-American men (27.8%). The occurrence of lung cancer in primarily young men is consistent with the observations of multiple other investigators. However, we share the concern of Sridhar et al that as the incidence of both lung cancer and HIV continue to rise in women, more cases of HIV-associated lung cancer will be observed in young women over the next several years.
Homosexual-bisexual men and IV drug users comprised the mode of HIV transmission in approximately 80.5% of the primary lung carcinoma patients in the cohort. Similar demography has been observed by other investigators.
In accord with many other studies, all of the major histologic cell types of primary lung carcinoma were observed (Table 6). Likewise, adenocarcinoma was the most frequently observed histology (11.8%). However, nine cases (11.8%) were non-small cell carcinomas, not otherwise specified. Thus, the frequency of histologic subgroups may actually be slightly different than illustrated in Table 6 based on the true cellularity of these nine cases. (more…)

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  • AIDS-Related Bronchogenic Carcinoma.Fact or Fiction: DeliberationA potential problem with the conclusions of these later studies may simply be related to their timing relative to the onset and management of the AIDS epidemic. These later studies, especially that of Biggar et al and Chan et al, were performed early in the AIDS epidemic, when most infected patients rapidly died of OIs. Our study and conclusion are conducted later in the AIDS epidemic, at a time when these previously life-threatening OIs are better managed. Infected patients now live longer, allowing for the development and recognition of these previously unrecognized neoplasms.
    The earliest study with the strongest evidence that the frequency of lung cancer was increased in HIV-AIDS patients was by Braun et al. They suggested a 14-fold increased incidence of lung cancer in these patients. Sridhar et al reported a series of 19 HIV-positive patients with concomitant lung carcinoma. Prior to our report, Fishman et al had the largest reported series with 30 HIV-positive patients diagnosed as having primary lung cancer. (more…)

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  • Patients infected with HIV and AIDS are at increased risk of OIs. As more efficacious means of therapy and prevention have developed, these previously life-threatening OIs have become less enigmatic. HIV-AIDS patients now live longer with delays in progression to symptomatic disease. The longevity of these patients is now complicated by a new challenge, HIV-AIDS-related neoplasms.
    The development of malignant neoplasms in im-munodeficient states has been well documented in various primary immunodeficiency diseases (eg, Wiskott-Aldrich syndrome, ataxia telangiectasia, X-linked Bruton’s type agammaglobulinemia, X-linked lymphoproliferative syndrome), and secondary immunodeficiency states induced by immunosuppressive drugs (eg, organ transplantation, cytotoxic cancer chemotherapy). (more…)

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  • AIDS-Related Bronchogenic Carcinoma.Fact or Fiction: ResultsTable 2 demonstrates the demographic variables observed within the HIV-AIDS cohort and the age at which both the diagnosis of HIV-AIDS and of lung neoplasm was established. Thirty-five of the 36 primary lung carcinoma patients were male (97.2%). Twenty-four (66.7%) of the patients were white and 10 patients (27.8%) were African-Americans. The median age at time of HIV-AIDS diagnosis among the primary lung cancer patients was 48 years. The median age at time of diagnosis of lung neoplasm was 49 years.
    Homosexual/bisexual and/or IV drug user male subjects accounted for 80% of the HIV transmission among the 36 lung neoplasm patients. Table 3 summarizes the mode of HIV transmission in our cohort. (more…)

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  • A total of 26,181 cases in the HIV-AIDS file were matched against all lung neoplasms diagnosed in Texas between 1990 and 1995. Matching criteria based on surname, first name, social security number, date of birth, and residence were used to identify absolute and probable matches. Probable matches were then manually reviewed to determine accurate match status.
    The number of incident primary lung cancers expected among the HIV-AIDS cohort was calculated based on the US age- and sex-specific lung cancer incident rates published by the National Cancer Institute’s, Surveillance, Epidemiology, and End Results (SEER) Program. These rates were used to calculate the number of cases expected for male and for female subjects within each race/ethnicity category. These age-adjusted, race-specific expected numbers were then summed to give an overall expected number. (more…)

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  • AIDS-Related Bronchogenic Carcinoma. Fact or Fiction?

    Mar 18, 2014 Author: Walter Mcneil | Filed under: Bronchogenic Carcinoma

    AIDS-Related Bronchogenic Carcinoma.Fact or Fiction?Multiple investigators have demonstrated an increased frequency of malignant neoplasms in the HIV-AIDS patient population. Kaposi’s sarcoma and malignant lymphoma are the two most widely recognized and documented associated neoplasms. The association of other non-AIDS-defining neoplasms has been regarded as somewhat more controversial. The association of primary lung carcinoma is one of these controversies. Several case reviews and retrospective analyses have raised the possibility of an increased frequency of primary lung carcinoma in this patient population. Analyses and results have often been conflicting or inconclusive. To our knowledge, no conclusive epidemiologic data have yet linked these two diseases. (more…)

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  • The Changing Radiographic Presentation of Bronchogenic Carcinoma With Reference to Cell Types (Discussion )Our study was designed to determine if the chest radiographic appearance at presentation of the different cell types of lung cancer has changed in the last 30 to 40 years. We wished to reexamine this issue because of a reported increased frequency of adenocarcinoma in both sexes and a higher lung cancer incidence in women since prior reports were published. We do not possess any significant number of original chest radiographs of lung cancer patients from the 1950s and 1960s. Therefore, we compared our series of newly diagnosed lung cancer cases with a widely referenced report from the Mayo Clinic compiled in that time period. Our patient population included 33.6% women, in contrast to 13.7% in the older Mayo Clinic series. The American Cancer Society estimates that 44% of new lung cancer cases in 1996 will occur in women/ Furthermore, in 1992 (the last year of our study), the same source reported that 37% of lung cancer deaths were in women.’ Therefore, our numbers are in accord with current national trends. (more…)

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  • The Changing Radiographic Presentation of Bronchogenic Carcinoma With Reference to Cell Types (Results)Four hundred fifty-four cases were identified from the Marshfield Clinic Tumor Registry. These cases had been diagnosed between October 1990 and August 1992. Of these cases, the initial chest radiograph was available in 345 (76%) instances, and these formed the basis of our analysis.

    The population included 116 (34%) female patients. The age range was 37 to 88 years with a median of 68 years. Frequency of each cell type is shown in Table 2. In the Marshfield Clinic series, adenocarcinoma was the most frequent type, followed by squamous cell, small cell, and large cell carcinoma. These frequencies are in marked contrast to the Mayo Clinic series. After grouping the infrequent bronchoalveolar and ade-nosquamous cases into an “other’ categoiy, the differences in relative frequencies of the cell types for the two series were highly significant (p<0.001). (more…)

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