Effect of Solvent Drag

Abstract

To the Editor:Although the diagnosis of Kaposi's sarcoma of the tracheobronchial tree can sometimes be made histologically by biopsy at fiberoptic bronchoscopic examination in the setting of the acquired immune deficiency syndrome, we feel that biopsy of these tracheobronchial lesions is usually unnecessary; the diagnosis of widespread Kaposi's sarcoma is frequently already established histologically (ie, by skin or lymph node biopsy). The tracheal and bronchial lesions are highly characteristic in appearance and they may bleed when biopsied. Further, the diagnostic yield of biopsy samples may be low.We have now performed fiberoptic bronchoscopic examination on nine patients who had endobronchial and/or tracheal lesions which appeared characteristic of Kaposi's sarcoma (ie, brightly red to violaceous vascular lesions). As in the case reported by Lau and colleagues, all nine patients had Kaposi's sarcoma extensively involving the skin, proven by biopsy prior to the fiberoptic bronchoscopic examinations (which were performed to diagnose unexplained pulmonary infiltrates). The diagnosis of Kaposi's sarcoma of the tracheobronchial tree was made from bronchial biopsy samples in only one (11 percent) of these nine patients, but was confirmed at autopsy in an additional five patients. Three (33 percent) of the nine patients had self-limited 20 to 50 ml mucosal bleeds following the bronchial biopsy procedure. To the Editor: Although the diagnosis of Kaposi's sarcoma of the tracheobronchial tree can sometimes be made histologically by biopsy at fiberoptic bronchoscopic examination in the setting of the acquired immune deficiency syndrome, we feel that biopsy of these tracheobronchial lesions is usually unnecessary; the diagnosis of widespread Kaposi's sarcoma is frequently already established histologically (ie, by skin or lymph node biopsy). The tracheal and bronchial lesions are highly characteristic in appearance and they may bleed when biopsied. Further, the diagnostic yield of biopsy samples may be low. We have now performed fiberoptic bronchoscopic examination on nine patients who had endobronchial and/or tracheal lesions which appeared characteristic of Kaposi's sarcoma (ie, brightly red to violaceous vascular lesions). As in the case reported by Lau and colleagues, all nine patients had Kaposi's sarcoma extensively involving the skin, proven by biopsy prior to the fiberoptic bronchoscopic examinations (which were performed to diagnose unexplained pulmonary infiltrates). The diagnosis of Kaposi's sarcoma of the tracheobronchial tree was made from bronchial biopsy samples in only one (11 percent) of these nine patients, but was confirmed at autopsy in an additional five patients. Three (33 percent) of the nine patients had self-limited 20 to 50 ml mucosal bleeds following the bronchial biopsy procedure. Effect of Solvent DragCHESTVol. 89Issue 1PreviewTo the Editor: Full-Text PDF