Hasan F A, Jeffers L J, Dickinson G, Otrakji C L, Greer P J, Reddy K R, Schiff E R
Department of Hepatology, University of Miami School of Medicine, Florida.
Gastroenterology. 1991 Jun;100(6):1743-8. doi: 10.1016/0016-5085(91)90678-e.
A cholestatic syndrome caused by sclerosing cholangitis and papillary stenosis has been described in patients with the acquired immunodeficiency syndrome and hepatobiliary cryptosporidiosis and cytomegalovirus infection. The case of a 41-year-old homosexual man with the acquired immunodeficiency syndrome who presented with abdominal pain, diarrhea, fever, and cholestasis is reported. A percutaneous transhepatic cholangiogram showed that the extrahepatic and right-sided intrahepatic ducts were normal. Computerized tomography of the abdomen showed multiple hypodense lesions in the liver. Guided needle biopsies of several of these lesions showed severe confluent necrotizing pericholangitis with cytomegalovirus-infected cells. Numerous cryptosporidia were seen attached to biliary epithelium. The unique histopathologic and radiographic features of this case should be added to the spectrum of hepatobiliary manifestations of the acquired immunodeficiency syndrome.
在获得性免疫缺陷综合征患者以及合并肝胆隐孢子虫病和巨细胞病毒感染的患者中，已描述了一种由硬化性胆管炎和乳头狭窄引起的胆汁淤积综合征。本文报告了一名41岁患有获得性免疫缺陷综合征的同性恋男子，他出现腹痛、腹泻、发热和胆汁淤积症状。经皮肝穿刺胆管造影显示肝外胆管和右侧肝内胆管正常。腹部计算机断层扫描显示肝脏有多个低密度病变。对其中几个病变进行的引导下针吸活检显示严重的融合性坏死性胆管周围炎，伴有巨细胞病毒感染的细胞。可见大量隐孢子虫附着于胆管上皮。该病例独特的组织病理学和影像学特征应补充到获得性免疫缺陷综合征的肝胆表现谱中。
