Lung cancer as the presenting feature of AIDS

Several reports have suggested that there is an increased incidence of lung cancer amongst the HIV positive population. All cases of lung cancer reported in this group to date were in patients known previously to be HIV positive. We now report a case of AIDS presenting with small cell lung cancer. Unexpectedly severe pancytopenia and immunosuppression after combination chemotherapy revealed the underlying diagnosis. The prognosis in such cases is very poor, but it is important to establish the correct diagnosis in order for patients to make informed treatment decisions and to allow potentially life-saving treatment of their sexual partners.