Working for healthier lungs. The 1989 winter meeting of the British Thoracic Society. 7 and 8 December, London. Abstracts.

The differentiation between Pneumocystis carinii pneumonia (PCP) and Kaposi's sarcoma can be difficult if an HIV positive patient presents with alveolar consolidation and/or interstitial shadowing on the chest radio- graph (CXR).We have compared the CXR and thoracic computed tomographic (CT) appearances of 31 HIV positive males during acute respiratory episodes in order to evaluate the role of CT in distinguishing PCP from Kaposi's sarcoma.In group 1 sixteen patients had PCP.Eleven patients in group 2 had Kaposi's sarcoma and in group 3 four patients had both PCP and Kaposi's sarcoma.Both CXR and CT were categorised as being normal (N) or showing one or more of the following abnormalities: interstitial shadow- ing (INT); alveolar consolidation (ALV); intrapulmonary nodules < 1 cm diameter (NOD); mediastinal and/or hilar lymphadenopathy (LN); pleural effusions (EFF); cystic air spaces (C); and on CT bronchial wall thickening (BT).Results were as follows: Interstitial shadowing, alveolar consolidation and intrapulmonary nodules do not help distinguish Kaposi's sarcoma from PCP.The presence of bronchial wall thickening and cystic air spaces suggest a diagnosis of PCP whereas pleural effusions and lymphadenopathy suggests Kaposi's sarcoma.These abnormalities, which are better demonstrated by CT, help distinguish PCP from intrapul- monary Kaposi's sarcoma.N INTALVNODLNEFF C BT Group I CXR 0 14 4 1 1 2 3 0 (n= 16) CT 0 14 10 7 5 2 6 9 Group2 CXR0 9 5 5 2 7 0 0 (n= 11) C 0 O 9 5 9