Witte M H, Fiala M, McNeill G C, Witte C L, Williams W H, Szabo J
Department of Surgery, University of Arizona College of Medicine, Tucson 85724.
AJR Am J Roentgenol. 1990 Aug;155(2):311-5. doi: 10.2214/ajr.155.2.2115258.
Kaposi sarcoma, a common opportunistic neoplasm complicating AIDS, is thought to arise from the vasculature and possibly from lymphatic endothelium. To evaluate the nature and extent of lymphatic involvement in AIDS-associated Kaposi sarcoma, we used an improved technique of whole-body lymphangioscintigraphy. Six human-immunodeficiency-virus-seropositive men (40-51 years old) with AIDS and extensive Kaposi sarcoma had bilateral foot and/or hand intradermal injection of 0.05 ml of 99mTc-labeled human serum albumin (500 microCi, 18.5 MBq). After sequential whole-body scanning with a digital gamma camera, the findings were interpreted by comparing them with findings from similar studies in 30 other patients without AIDS or Kaposi sarcoma (26 with primary or secondary lymphedema and four with normal extremities). Unlike in normal limbs, where lymphangioscintigraphy displayed early lymphatic truncal and regional nodal filling with radionuclide, in patients with Kaposi sarcoma, lymphangioscintigraphy disclosed a variety of abnormal patterns with some features distinct and others resembling lymphatic dysplasia as seen in primary and secondary lymphedema. These included focal accumulation of tracer within lymphatic channels in the distribution of cutaneous Kaposi lesions; delayed tracer transport with absent, faint, or intense regional lymph nodal uptake; and retarded or impeded lymphatic drainage with tracer intensification in the region of Kaposi sarcoma plaques. The impaired lymphatic drainage and nodal dysfunction seen on scintigrams in patients with AIDS-associated Kaposi sarcoma suggest a close connection between the lymphatic system and this disorder.
卡波西肉瘤是艾滋病常见的机会性肿瘤，被认为起源于脉管系统，可能还源于淋巴管内皮。为评估艾滋病相关卡波西肉瘤中淋巴管受累的性质和程度，我们采用了改进的全身淋巴管闪烁造影技术。6名患有艾滋病且卡波西肉瘤广泛的人类免疫缺陷病毒血清阳性男性（40 - 51岁），在双侧足部和/或手部皮内注射了0.05毫升99mTc标记的人血清白蛋白（500微居里，18.5兆贝可）。在用数字伽马相机进行连续全身扫描后，将结果与30名无艾滋病或卡波西肉瘤的其他患者（26名患有原发性或继发性淋巴水肿，4名四肢正常）的类似研究结果进行比较后进行解读。与正常肢体不同，正常肢体淋巴管闪烁造影显示放射性核素早期充盈淋巴管主干和区域淋巴结，而在卡波西肉瘤患者中，淋巴管闪烁造影显示出多种异常模式，有些特征独特，有些类似于原发性和继发性淋巴水肿中所见的淋巴管发育异常。这些异常包括示踪剂在皮肤卡波西病变分布区域的淋巴管内局部积聚；示踪剂运输延迟，区域淋巴结摄取缺失、微弱或强烈；以及卡波西肉瘤斑块区域淋巴管引流受阻或受妨碍，示踪剂强化。艾滋病相关卡波西肉瘤患者闪烁造影所见的淋巴管引流受损和淋巴结功能障碍表明淋巴系统与这种疾病之间存在密切联系。
