ENDOBRONCHIAL LESIONS IN HIV-INFECTED INDIVIDUALS

Endobronchial manifestations of HIV infection are rare. The endobronch ial appearance and clinical presentation of these lesions may suggest the correct diagnosis. Establishing an appropriate differential diagno sis at the time of visualization of the endobronchial lesion is import ant because some lesions require specific biopsy techniques or special stains. The bronchoscopist must consider the risks vs benefits of bio psy when confronted with an endobronchial lesion. With the notable exc eption of pseudomembranous necrotizing tracheobronchial aspergillosis, there are no specific endobronchial lesions associated with HIV infec tion which increase the risk of complications when they are biopsied. Although EKS is a vascular lesion and an early case report suggested t hat endobronchial biopsy might result in excessive bleeding, this comp lication was not observed in two subsequent series. Fortunately, a pre sumptive diagnosis of EKS can usually be made without biopsy by the ch aracteristic appearance of the lesion. EKS is the most common endobron chial lesion associated with Hive infection; however, its incidence wi ll probably decline as the incidence of KS declines. Many of the other endobronchial lesions described herein have been reported recently. W e suspect these and other lesions will be found more frequently, as th e epidemic of HIV continues to evolve.