A comparison of the radiological features of lung cancer in HIV-infected and HIV-uninfected individuals in a South African hospital

Abstract

INTRODUCTION: Lung Cancer (LC) is one of the most important causes of death worldwide. With the increase in non-AIDS defining cancers, like LC, this is concerning in South Africa, with the country’s high incidence of HIV. AIM: To correlate the CT features of LC with the histological / cytological diagnoses and compare these findings in HIV-infected and HIV-uninfected patients.

METHOD: 54 patients with lung lesions on CT, who had image-guided, biopsy-proven malignancies were retrospectively reviewed.

RESULTS: The study population had a M:F ratio of 31:23, with 31.5% HIV-infected and a mean age of 59 years (SD±11). 85% had constitutional symptoms of LC and 59% had a smoking history. The most prevalent subtypes were squamous cell carcinoma (37%), adenocarcinoma (24.1%) and large cell carcinoma (24.1%). CT features were a mean axial lesion size anteroposterior of 67mm and transverse of 70mm, with an upper lobe predominance (76%). Other features were an irregular (70.4%), lobulated (55.6%) margin with pleural tags (61.1%) and spiculation (51.9%). Associated findings were CT significant mediastinal lymphadenopathy (77.8%), involvement of vessels or bronchi (68.5%), convergence of surrounding structures (64.8%), pleural effusion (55.6%) and secondary pulmonary lesions (51.9%). The HIV-infected patients had a mean age of 51 (SD±11) years iv and a strong Tuberculosis history (60%). There was no statistical difference in the imaging features between the HIV-infected and HIV-uninfected patients.

CONCLUSION: HIV-infected patients with LC present younger. Larger studies are needed to confirm whether this subgroup has more atypical lesions and need a different set of criteria for CT evaluation.