Conrado P. Aranda

Diagnosis of pulmonary Kaposi's sarcoma with fiberoptic bronchoscopy and endobronchial biopsy. A report of five cases.

Fiberoptic bronchoscopy is a major tool in the diagnostic evaluation of pulmonary disease in patients with the Acquired Immune Deficiency Syndrome. Multiple opportunistic infections and Kaposis sarcoma affect the lung in this disorder. In contrast to opportunistic infections, Kaposis sarcoma is rarely reported to be diagnosed by means of bronchoscopy. This report describes five of seven patients in whom endobronchial lesions consistent with submucosal involvement by the tumor were seen, and Kaposis sarcoma was diagnosed without complication. Kaposis sarcoma must be considered in the differential diagnosis of pulmonary disease in patients with a proven extrapulmonary tumor focus, and fiberoptic bronchoscopy is the initial diagnostic procedure of choice. Endobronchial Kaposis sarcoma may be a marker for parenchymal involvement by the tumor. Diagnosis of endobronchial Kaposis sarcoma can be an important factor in decisions regarding therapy. Cancer 59:807‐810, 1987.

Pulmonary granulomata. A complication of intravesical administration of bacillus Calmette-Guerin for superficial bladder carcinoma.

Intravesical administration of bacillus Calmette‐Guerin (BCG) is an effective treatment for superficial carcinoma of the bladder. The authors report a pulmonary complication characterized by miliary infiltration on chest roentgenogram and caseating granulomata on lung biopsy specimens. This case and three prior reports suggest that this complication may be a form of hypersensitivity rather than true BCG infection.

Necrotizing pneumonitis caused by 5‐fluorouracil infusion. A complication of a hickman catheter

The authors report the case of a patient with a Hickman catheter that migrated into the lung parenchyma. The resultant inadvertent infusion of 5‐fluorouracil caused necrotizing chemical pneumonitis. Possible mechanisms of catheter migration include the lateral orientation of the catheter tip and the partial thrombosis of the innominate vein and superior vena cava. The patient recovered but had residual contraction fibrosis of the right upper lobe of the lung. Cancer 1992; 70:554‐556.