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Cryptococcus neoformans continues to present diagnostic and treatment challenges in patients with underlying malignant neoplasms. Cryptococcal empyema is a relatively rare complication of cryptococcal disease. It is important to distinguish whether uncontrolled malignancy or cryptococcal infection is responsible for the effusion. We used traditional diagnostic approaches, bronchoscopy and transthoracic fine needle aspiration, to verify the presence of the organism but continued to have treatment failure until adequate drainage was established. (Chest 1992; 101:586-88) TFNA=transthoracic fine needle aspiration, Cryptococcus neoformans is a ubiquitous fungus found in the soil. On inhalation, a complex, incompletely understood series of host responses begins that determines whether the infection will be controlled or [...]

Infection with human immunodeficiency virus (HIV) is associated with the development of a wide variety of malignancies. The most common cancer associated with HIV infection is Kaposi's sarcoma. Other types of malignancies associated with HIV infection include cancers of the lymphatic system, bone marrow, mouth, testes, and anus. A case is described of a 43-year-old man with HIV infection who developed small cell cancer of the rectum. The patient, an anoreceptive homosexual male, was admitted with a seven-week history of rectal bleeding, constipation, thin stools, and tenesmus, or spasms of the anal sphincter. He was found to have a painless, rectal mass, and biopsy of the rectal mass indicated it was small cell cancer. The patient was treated with several anticancer agents and radiation therapy, but died from complications of the tumor eight months after his initial diagnosis and therapy. These results and findings from other studies suggest that sexual practice and viral species other than HIV may play a role in the development of anorectal cancer in patients with acquired immunodeficiency syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)