Cornett Daniel, Benson Mark, Attia Steven, Weiss Jennifer, Gopal Deepak
Division of Gastroenterology and Hepatology, University of Wisconsin Hospital and Clinics, Madison, Wisc., USA.
Case Rep Gastroenterol. 2011 May;5(2):416-21. doi: 10.1159/000330480. Epub 2011 Jul 22.
AIDS-related Kaposi's sarcoma (KS) is a low-grade vascular tumor that occurs in association with human herpesvirus 8 infection. Here we report the case of a 21-year-old male with recently diagnosed cutaneous KS who presented with rectal bleeding and anal pruritus. Initial endoscopic evaluation was nondiagnostic. CT imaging showed diffuse lymphadenopathy including perirectal involvement which was suspicious for metastatic KS. Echoendoscopy with needle biopsies and EchoBrush sampling of the lymph nodes revealed spindle cells confirming metastatic KS. Treatment was initiated with liposomal doxorubicin resulting in rapid improvement of the skin lesions. After treatment completion, repeat CT imaging showed improved lymphadenopathy. No further rectal bleeding or perianal pruritus was reported. Although the EchoBrush has previously been used to aid in the diagnosis of pancreatic lesions, this report describes a novel use of EchoBrush to diagnose KS from perirectal lymph nodes.
艾滋病相关的卡波西肉瘤（KS）是一种低度血管肿瘤，与人类疱疹病毒8感染相关。在此，我们报告一例21岁男性病例，该患者近期诊断为皮肤KS，表现为直肠出血和肛门瘙痒。最初的内镜评估未得出诊断结果。CT成像显示弥漫性淋巴结病，包括直肠周围受累，怀疑为转移性KS。超声内镜引导下对淋巴结进行针吸活检和EchoBrush采样，发现梭形细胞，证实为转移性KS。开始使用脂质体阿霉素治疗，皮肤病变迅速改善。治疗完成后，重复CT成像显示淋巴结病有所改善。未再报告直肠出血或肛周瘙痒。尽管EchoBrush此前已用于辅助诊断胰腺病变，但本报告描述了EchoBrush在诊断直肠周围淋巴结KS中的新用途。
