Sanya E O, Adido J, Owoeye J F A, Ayanniyi A A, Buhari M O, Yusuf I F, Rahman G A
Department of Medicine, University of Ilorin Teaching Hospital, Kwara State Nigeria.
West Afr J Med. 2008 Jan;27(1):50-2.
Neoplastic conditions are increasingly been encountered in HIV/AIDS patients. Till date only two cases of conjunctiva Kaposi sarcoma (KS) have been reported in the background of HIV and both in males.
To present a 27-year-old African woman with histologically proven conjunctival KS and marked CD4+ cell depletion and to reinforce the fact that KS is an important differential of conjunctival tumour especially in the background of immunosupression in Africa.
A 27-year-old housewife, presented to the hospital with a three-month history of a rapidly growing tumour attached to the right upper eyelid, cough and weight loss. Patient was given full workup including x-rays, HIV status determination and histological assessment.
She was markedly wasted, with widespread pruritic papular skin lesion, and florid oropharyngeal candidiasis. Clinical and chest x-ray findings were suggestive of bilateral lower lobar pneumonia. Screening and confirmatory tests were positive for human immunodeficiency virus (HIV) with CD4+ lymphocyte cell count of 120 cells/ml. Histologic report of the biopsy revealed the mass to be a conjunctival KS. Patient was subsequently commenced on antibiotics and antiretroviral combination therapy. The mass had regressed in size considerably along with improvement in her clinical condition at six months review. She is still being followed up at the medical clinic.
This is the first reported case of conjunctival KS in an HIV positive African woman. KS should be considered as a possible differential of conjunctiva mass, especially if the patient is HIV positive irrespective of patient's gender.
肿瘤性疾病在艾滋病毒/艾滋病患者中越来越常见。迄今为止,仅报告了两例在艾滋病毒背景下发生的结膜卡波西肉瘤(KS),且均为男性。
报告一名27岁的非洲女性,经组织学证实患有结膜KS且CD4+细胞明显减少,以强调KS是结膜肿瘤的重要鉴别诊断,尤其是在非洲免疫抑制背景下。
一名27岁的家庭主妇因右上眼睑附着的肿瘤迅速生长、咳嗽和体重减轻3个月前来就诊。患者接受了全面检查,包括X光检查、艾滋病毒状态测定和组织学评估。
她明显消瘦,有广泛的瘙痒性丘疹性皮肤病变和严重的口咽念珠菌病。临床和胸部X光检查结果提示双侧下叶肺炎。人类免疫缺陷病毒(HIV)筛查和确诊试验呈阳性,CD4+淋巴细胞计数为每毫升120个细胞。活检的组织学报告显示肿块为结膜KS。患者随后开始接受抗生素和抗逆转录病毒联合治疗。在6个月复查时,肿块大小明显缩小,临床状况有所改善。她仍在诊所接受随访。
这是首例报告的艾滋病毒阳性非洲女性结膜KS病例。KS应被视为结膜肿块的可能鉴别诊断,尤其是如果患者艾滋病毒呈阳性,无论患者性别如何。