Taccogna Silvia, Crescenzi Anna, Stasi Roberto, Turrini Luca, Gallo Annalisa, Rossi Zaccaria
Regina Apostolorum Hospital, Surgical Pathology, via S. Francesco 50, Rome, 00041, Italy.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.03.2009.1666. Epub 2009 Jul 14.
A 60-year-old man presented with persistent dysphagia and weight loss of 2-months duration. An upper GI endoscopy revealed mycotic oesophagitis and chronic gastritis with two ulcers of the gastric body and antrum. Repeat endoscopy was performed after medical treatment failed, and histological examination on new biopsy samples led to a diagnosis of Kaposi sarcoma of the stomach. HIV infection was not known at this time; however, the patient was tested after the diagnosis of Kaposi sarcoma was made and found to be HIV positive. An adequate biopsy sampling was required for histological diagnosis and the use of immunohistochemical markers, especially human herpesvirus 8 (HHV8) antibodies, supplied valid diagnostic support. This case underlines the importance of an accurate evaluation of vascular proliferation in gastrointestinal biopsies even in patients without clinical evidence of HIV-related pathology.
一名60岁男性,出现持续吞咽困难和体重减轻2个月。上消化道内镜检查显示霉菌性食管炎和慢性胃炎,胃体和胃窦有两个溃疡。药物治疗失败后进行了重复内镜检查,新活检样本的组织学检查诊断为胃卡波西肉瘤。当时未知该患者感染HIV;然而,在诊断为卡波西肉瘤后对患者进行检测,发现其HIV呈阳性。组织学诊断需要足够的活检样本,免疫组化标志物的使用,尤其是人类疱疹病毒8(HHV8)抗体,提供了有效的诊断支持。该病例强调了即使在没有HIV相关病理临床证据的患者中,准确评估胃肠道活检中血管增殖的重要性。