艾滋病合并卡波西肉瘤多脏器组织侵犯的影像学分析

新发传染病电子杂志 ›› 2020, Vol. 5 ›› Issue (1): 8-15.

艾滋病合并卡波西肉瘤多脏器组织侵犯的影像学分析

卢亦波¹, 施裕新², 刘晋新³, 张倩倩^4,5, 谢汝明⁶, 鲁植艳⁷, 杨豫新⁸, 张娜⁹, 郑广平⁴, 叶雯², 陈步东⁶, 吴锋耀¹, 李宏军¹⁰, 陆普选^4,11

1.南宁市第四人民医院重症医学科,南宁 530023;
2.上海市（复旦大学附属）公共卫生临床中心放射科,上海 201805;
3.广州市第八人民医院放射科,广州 510060;
4.深圳市第三人民医院放射科,广东深圳 518112;
5.河南省周口市中心医院放射科,河南周口 466000;
6.首都医科大学附属北京地坛医院放射科,北京 100015;
7.武汉大学中南医院放射科,武汉 430017;
8.新疆维吾尔自治区第六人民医院放射科,乌鲁木齐 830000;
9.成都市公共卫生临床中心放射科,成都 610000;
10.首都医科大学附属北京佑安医院放射科,北京 100069;
11.深圳市慢性病防治中心医学影像科,广东深圳 518020

出版日期:2020-01-20 发布日期:2020-04-22
通讯作者: 陆普选,Email: lupuxuan@126.com
基金资助:
1.国家自然科学基金重点项目（61936013）; 2.南宁市科学研究与技术开发项目重大专项（20193008）; 3.南宁市兴宁区科学研究与技术开发项目（2018A06）; 4.南宁市科学研究与技术开发计划基金资助项目（20173157-6）; 5.北京市重点医学专业发展计划（ZYLX201511）; 6.中国疾病预防控制中心专项（2018-65）; 7.上海市科学技术委员会项目（19411965800）; 8.上海市科学技术委员会项目（18411967100）

Image analysis of multiple organ invasion in acquired immunodeficiency syndrome patients with Kaposi's sarcoma

Lu Yibo¹, Shi Yuxin², Liu Jinxin³, Zhang Qianqian^4,5, Xie Ruming⁶, Lu Zhiyan⁷, Yang Yuxin⁸, Zhang Na⁸, Zheng Guangping⁴, Ye Wen², Chen Budong⁶, Wu Fengyao¹, Li Hongjun¹⁰, Lu Puxuan^4,11

1.Department of Critical Medicine, The Fourth People's Hospital of Nanning, Nanning 530023,China;
2.Department of Radiology, Shanghai Public Health Clinical Center, Shanghai 201805,China;
3.Department of Radiology, The Eighth People's Hospital of Guangzhou, Guangzhou 510060,China;
4.Department of Radiology, The Third People's Hospital of Shenzhen, Guangdong Shenzhen 518112, China;
5.Department of Radiology, Henan Zhoukou central hospital, Henan Zhoukou 466000, China;
6.Department of Radiology, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China;
7.Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan 430017, China;
8.Department of Radiology, The Sixth People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830000, China;;
9.Department of Radiology, Chengdu Public Health Clinical Center, Chengdu 610000, China;
10.Department of Radiology, Beijing You’an Hospital, Capital Medical University, Beijing 100069, China;;
11.Department of Radiology, Shenzhen Center for Chronic Disease Control,Guangdong Shenzhen 518020, China

Online:2020-01-20 Published:2020-04-22

摘要/Abstract

摘要： 目的分析艾滋病合并卡波西肉瘤多脏器组织侵犯的临床及影像学表现,提高对艾滋病合并卡波西肉瘤的认识,为临床诊断及治疗提供依据。方法收集国内多家传染病专科医院确诊的艾滋病合并卡波西肉瘤的相关资料,根据纳入标准及排除标准,对48例患者的临床表现、影像学及病理资料进行回顾性分析。结果 48例艾滋病合并卡波西肉瘤患者,CD4⁺T细胞计数低于100个/UL者37例（77.1%）。48例患者中肺部受侵38例,影像表现为结节影者30例（30/38,78.9%）,CT横断位肺窗、纵隔窗及冠状位伪彩重建示两肺大小不等以血管分布为主的结节,表现为两肺广泛与肺血管相连的结节影,或呈火焰状/星星状、挂果征等改变;肝脏卡波西肉瘤7例,影像表现为结节、肝内胆管扩张;艾滋病合并卡波西肉瘤中食管、胃和肠管受侵3例,镜下见散在紫红色结节样隆起;合并甲状腺受侵者1例,表现为低密度结节;合并肋骨及上颌骨受侵者各1例,均表现为溶骨性骨质破坏并周围软组织结节。48例患者中侵犯两个以上脏器或组织者44例。结论艾滋病合并卡波西肉瘤侵犯多脏器组织的影像表现主要是多形性与血管相连的结节病灶。艾滋病相关卡波西肉瘤同时合并有肺、肝脏、消化道、甲状腺、肋骨及上颌骨等卡波西肉瘤浸润,其影像学表现亦是与血管密切相关的不规则结节病灶为主。

关键词: 艾滋病, 卡波西肉瘤, 脏器/组织, 计算机体层摄影, 磁共振成像

Abstract: Objective To analyze the clinical imaging manifestations of multiple organ tissue invasion of AIDS with Kaposi's sarcoma, to improve the understanding of AIDS with kaposi's sarcoma, and provide the basis for clinical diagnosis and treatments. Methods Relevant datas of AIDS complicated with Kaposi's sarcoma diagnosed in several infectious hospitals in China were collected. According to the inclusion and exclusion criteria, clinical manifestations, imaging and pathological data of 48 patients meeting the requirements were sorted and analyzed. Results In 48 patients with AIDS with Kaposi's sarcoma, CD4⁺ T cell count was lower than 100 /UL in 37 patients (77.1%). 38 patients suffered from lung invasion, and 30 patients (30/38,78.9%) presented nodular shadows on the images. CT transversely located pulmonary window and mediastinal window, as well as coronal pseudocolor reconstruction, showed nodules with different lung sizes and vascular distribution. which were characterized by nodules of both lungs widely connected with pulmonary vessels, or flame-like/star-like, fruit hanging signs. Kaposi's sarcoma of the liver showed nodules and intrahepatic bile duct dilatation in 7 cases. 3 patients with AIDS complicated with Kaposi's sarcoma suffered from esophageal, gastric and intestinal invasion. 1 case with thyroid invasion showed low-density nodules. 1 case of rib invasion and 1 case of maxillary invasion were lytic destruction and surrounding soft tissue nodules. Two or more organs and organizers were involved in 44 cases. Conclusion The main imaging manifestations of multiple organs of AIDS with Kaposi's sarcoma are pleomorphic and vascular nodules. AIDS complicated with kaposi's sarcoma is accompanied by invasion of lung, liver, digestive tract, thyroid, rib and maxilla, and their imaging manifestations are mainly irregular nodules closely related to blood vessels.

Key words: Acquired immunodeficiency syndrome, Kaposi's sarcoma, Viscera/Tissues, Computed tomography, Magnetic resonance imaging

卢亦波, 施裕新, 刘晋新, 张倩倩, 谢汝明, 鲁植艳, 杨豫新, 张娜, 郑广平, 叶雯, 陈步东, 吴锋耀, 李宏军, 陆普选. 艾滋病合并卡波西肉瘤多脏器组织侵犯的影像学分析[J]. 新发传染病电子杂志, 2020, 5(1): 8-15.

Lu Yibo, Shi Yuxin, Liu Jinxin, Zhang Qianqian, Xie Ruming, Lu Zhiyan, Yang Yuxin, Zhang Na, Zheng Guangping, Ye Wen, Chen Budong, Wu Fengyao, Li Hongjun, Lu Puxuan. Image analysis of multiple organ invasion in acquired immunodeficiency syndrome patients with Kaposi's sarcoma[J]. Electronic Journal of Emerging Infectious Diseases, 2020, 5(1): 8-15.

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