AIDS and malignant mesothelioma--is there a connection?

Our plain-English summary of AIDS and malignant mesothelioma--is there a connection?, by C.A. Behling, P.L. Wolf, P. Haghighi (Chest, 1993).

The study

• Authors: C.A. Behling, P.L. Wolf, P. Haghighi
• Journal: Chest
• Published: 1993;103(4):1268-9
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 35-year-old male homosexual, a former intravenous drug abuser, was found to be human immunodeficiency virus (HIV) positive in 1984. He developed AIDS in 1987 and began treatment with zidovudine in 1989. One year later he developed left apical pleural blebs, a pneumothorax and an exudative pleural effusion. A malignant mesothelioma developed at the pleural blebs in the left apex. He was treated with adriamycin but rapid progression of the malignancy occurred and he died three months later. At autopsy, a malignant mesothelioma, causing respiratory failure and death, was found. The patient had no exposure to asbestos and asbestosis was not present at autopsy. We postulate that the development of malignant mesothelioma was probably related to HIV immune suppression or HIV and/or cytomegalovirus or zidovudine and is a complication of AIDS similar to the development of other malignant neoplasms in patients with AIDS.

In plain English

This article was a case report about one patient, written by pathologists in San Diego. The patient was a 35-year-old man who had been HIV-positive since 1984 and was given zidovudine from 1989. In September 1990 he developed chest pain and coughed up blood. He had blebs on the pleura at the top of the left lung, air around that lung (pneumothorax), and a small fluid collection. Tissue removed at surgery was reported as malignant mesothelioma; a consultant suggested reactive tissue caused by Pneumocystis pneumonia (PCP), but the patient did not have PCP and bronchoscopy specimens were negative for it. Despite radiation and low-dose weekly adriamycin, the disease progressed and he died on February 5, 1991. At autopsy, a tumor arising from the pleural surface had nearly replaced the left lung and had spread to other sites. The authors found no evidence of asbestos exposure and no asbestos in the tissue specimens. They said the link with AIDS might be purely chance, but suggested the mesothelioma was connected to AIDS, possibly through HIV immune suppression, HIV, cytomegalovirus or zidovudine.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (a single patient)
• Who was studied: One 35-year-old man, HIV-positive since 1984, with AIDS-related complex diagnosed in 1987. He was seen by the authors' department (Veterans Administration Medical Center and University of California, San Diego) from November 1989 until his death in February 1991.
• Exposure: No asbestos exposure was found in the patient's history or in the surgical or autopsy specimens. The patient also had no history of irradiation or of exposure to nickel, silica, beryllium, erionite or organic chemicals. The factors the authors proposed were HIV infection and immune suppression, cytomegalovirus, and zidovudine treatment.
• Main results:
  • In September 1990 the patient had chest pain and hemoptysis (coughing up blood). He was found to have apical pleural blebs, a left apical pneumothorax and a small left pleural exudative effusion. Cytology on sputum and pleural fluid was negative for malignancy.
  • After thoracotomy with excision of the bullae and mass, the final pathology report was malignant mesothelioma.
  • A consultant suggested the nodule was reactive mesothelium in response to PCP. The authors noted that the patient did not have PCP and that the bronchoscopy specimens were negative for PCP.
  • The patient was treated with irradiation and low-dose weekly adriamycin. By January 1991 the malignant mesothelioma had progressed markedly, and the patient died on February 5, 1991.
  • At autopsy, a necrotic, hemorrhagic malignant tumor had nearly completely replaced the left lung. It was adherent to the parietal pleura and invaded the mediastinum and pericardium.
  • Special stains were consistent with malignant mesothelioma: the tumor cells were positive for cytokeratin and vimentin and negative for carcinoembryonic antigen.
  • Metastatic malignant mesothelioma was found over the left cerebral hemisphere, in abdominal, bronchial and hilar lymph nodes, on the epicardium and in the right kidney.
• The authors' conclusion: The authors suggested that this patient's malignant mesothelioma had an AIDS connection. They postulated that it was probably related to HIV immune suppression, HIV, cytomegalovirus or zidovudine, and that it was a complication of AIDS similar to other cancers seen in AIDS patients.
• Limitations the authors state:
  • The authors stated that mesothelioma developing in a patient with AIDS may be purely fortuitous (chance).
  • The authors noted that the causes of cancers in AIDS patients have not been determined.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Pneumothorax, Pleural Effusion, Autopsy, Neoplasm.

Related studies

• Apoptosis and asbestos-induced disease: Is there a connection? — V.C. Broaddus (2001)
• Cosmetics use and age at menopause: is there a connection? — E.T. Chow, S. Mahalingaiah (2016)
• Mesothelioma in an HIV/AIDS patient without history of asbestos exposure: possible role for immunosuppression in mesothelioma: a case report — C.O. James, A.W. Woods, et al. (2009)
• Analyses of merlin/NF2 connection to FAK inhibitor responsiveness in serous ovarian cancer — N.R. Shah, I. Tancioni, et al. (2014)
• Asbestos and stomach cancer in Japan--a connection? — E.W. Kiritani (1990)
• State-of-the-science assessment of non-asbestos amphibole exposure: is there a cancer risk? — C. Williams, L. Dell, et al. (2013)

Browse more research in Chest, or return to medical research.