Two cases of acute respiratory failure due to carcinomatous lymphangitis in HIV patients

Abstract

In HIV-infected patients, acute respiratory failure is usually due to infectious pneumonia. In this report, we describe two cases of acute respiratory failure in HIV patients with clinical presentation suggesting infectious pneumonia. In both cases, the clinical condition deteriorated and death occurred after several days despite therapy. In both cases bronchial biopsies confirmed bronchogenic carcinoma responsible for carcinomatous lymphangitis.

Fig. 1

The chest X-ray demonstrated bilateral predominant right peribronchovascular infiltration, and ground glass opacities located on the lower half of the right lung with a paracardiac opacity. A nodular pattern better seen on the lower part of the left lung was also observed. There was no significant pleural effusion nor mediastinal enlargement

Fig. 2

The CT scan showed pulmonary metastatic nodules, but also ground glass densities in dependent regions predominantly on the left side, with a small left pleural effusion