[Pseudomesotheliomatous carcinoma in HIV infection]

A 32-year-old man, known to have been HIV-positive for 6 years, was admitted to hospital because of dyspnoea and dry cough. For 8 months he had an HIV illness in stage C3 (Center for Disease Control and Prevention, Atlanta) with fever, weight loss and obviously reduced general and nutritional state. There was almost total auscultatory dullness over the right hemithorax and the chest radiogram showed massive right pleural effusion, as well as broad pleural deposits which were suspicious of tumours. The first pleural aspiration recovered 1000 ml exudate. An infectious cause could not be identified. As the effusion was refractory to treatment (301 of effusion were drained over several days), thoracoscopy was performed despite the patient's poor general condition. It revealed extensive tumour masses over the right pleura.

After the endoscopy the patient's condition deteriorated rapidly and he died 3 weeks after admission, only 1 1/2 months after onset of the first symptoms. Histological examination of the endoscopically obtained biopsy revealed large-cell carcinoma. The form of growth indicated that it was a pseudomesotheliomatous carcinoma.

No previous case of this type of tumour in an HIV-positive patient has been reported. This patient's course was less favourable than is expected in those without HIV infection.