Ling Jie, Coron Roger, Basak Prasanta, Jesmajian Stephen
Department of Internal Medicine, Sound Shore Medical Center, New Rochelle, USA.
Int J STD AIDS. 2013 Nov;24(11):908-11. doi: 10.1177/0956462413487517. Epub 2013 Aug 5.
Epidemic Kaposi's sarcoma remains the most common cancer in patients with human immunodeficiency virus and is associated with significant morbidity and mortality in AIDS patients. Primary visceral Kaposi's sarcoma (Kaposi's sarcoma without cutaneous lesions) presenting with lower gastrointestinal bleeding (LGIB) has rarely been reported. Though Kaposi's sarcoma can occur anywhere in gastrointestinal tract, gastrointestinal symptoms are often non-specific such as chronic blood loss anaemia, vomiting, diarrhoea, intestinal obstruction. In these patients, severe gastrointestinal bleeding requiring repeated blood transfusions is extremely rare. Clinicians should be aware of gastrointestinal tract Kaposi's sarcoma since visceral Kaposi's sarcoma can present in the absence of cutaneous involvement. Endoscopy with biopsy is useful in the diagnosis for severe LGIB in patients with AIDS. Furthermore, gastrointestinal Kaposi's sarcoma should be considered in the differential diagnosis of GI bleeding. We report a case of primary colonic KS who presented with recurrent GI bleeding which was eventually diagnosed by sigmoidoscopy and confirmed pathologically.
流行性卡波西肉瘤仍然是人类免疫缺陷病毒患者中最常见的癌症，并且与艾滋病患者的高发病率和死亡率相关。原发性内脏卡波西肉瘤（无皮肤病变的卡波西肉瘤）伴下消化道出血（LGIB）的情况鲜有报道。尽管卡波西肉瘤可发生于胃肠道的任何部位，但胃肠道症状通常不具有特异性，如慢性失血性贫血、呕吐、腹泻、肠梗阻。在这些患者中，需要反复输血的严重胃肠道出血极为罕见。临床医生应意识到胃肠道卡波西肉瘤，因为内脏卡波西肉瘤可在无皮肤受累的情况下出现。内镜检查及活检对于诊断艾滋病患者的严重LGIB很有用。此外，在胃肠道出血的鉴别诊断中应考虑胃肠道卡波西肉瘤。我们报告一例原发性结肠卡波西肉瘤病例,该患者表现为反复胃肠道出血，最终通过乙状结肠镜检查确诊并经病理证实。
