From the Departments of Diagnostic Radiology (S.J., K.S., A.O., C.T.J., K.M.E.) and Interventional Radiology (N.K.), University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030; Department of Diagnostic Radiology, Mayo Clinic, Scottsdale, Ariz (C.O.M.); Department of Radiology, University of Utah, Salt Lake City, Utah (A.S.); Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (M.G.L.); and Department of Radiology, University of Missouri Health Care, Columbia, Mo (A.H.G.).
Radiographics. 2018 Nov-Dec;38(7):2051-2068. doi: 10.1148/rg.2018180149. Epub 2018 Oct 19.
The risk of developing malignancy is higher in patients with human immunodeficiency virus (HIV) infection than in non-HIV-infected patients. Several factors including immunosuppression, viral coinfection, and high-risk lifestyle choices lead to higher rates of cancer in the HIV-infected population. A subset of HIV-related malignancies are considered to be acquired immunodeficiency syndrome (AIDS)-defining malignancies, as their presence confirms the diagnosis of AIDS in an HIV-infected patient. The introduction of highly active antiretroviral therapy (HAART) has led to a significant drop in the rate of AIDS-defining malignancies, including Kaposi sarcoma, non-Hodgkin lymphoma, and invasive cervical carcinoma. However, non-AIDS-defining malignancies (eg, Hodgkin lymphoma, lung cancer, hepatocellular carcinoma, and head and neck cancers) now account for an increasing number of cancer cases diagnosed in HIV-infected patients. Although the number has decreased, AIDS-defining malignancies account for 15%-19% of all deaths in HIV-infected patients in the post-HAART era. Most HIV-related malignancies in HIV-infected patients manifest at an earlier age with a more aggressive course than that of non-HIV-related malignancies. Understanding common HIV-related malignancies and their specific imaging features is crucial for making an accurate and early diagnosis, which impacts management. Owing to the weakened immune system of HIV-infected patients, other entities such as various infections, particularly opportunistic infections, are prevalent in these patients. These processes can have confounding clinical and imaging manifestations that mimic malignancy. This article reviews the most common AIDS-defining and non-AIDS-defining malignancies, the role of imaging in their diagnosis, and the imaging mimics of malignancies in HIV-infected patients. RSNA, 2018.
人类免疫缺陷病毒（HIV）感染者发生恶性肿瘤的风险高于非 HIV 感染者。多种因素包括免疫抑制、病毒合并感染和高危生活方式选择导致 HIV 感染者癌症发病率更高。HIV 相关恶性肿瘤中有一部分被认为是获得性免疫缺陷综合征（AIDS）定义性恶性肿瘤，因为其存在可在 HIV 感染者中确诊 AIDS。高效抗逆转录病毒疗法（HAART）的应用使 AIDS 定义性恶性肿瘤（如卡波西肉瘤、非霍奇金淋巴瘤和侵袭性宫颈癌）的发生率显著下降。然而，非 AIDS 定义性恶性肿瘤（如霍奇金淋巴瘤、肺癌、肝细胞癌和头颈部癌症）现在在 HIV 感染者中占越来越多的癌症病例。尽管数量有所减少，但 AIDS 定义性恶性肿瘤在 HAART 后时代占 HIV 感染者所有死亡人数的 15%-19%。HIV 感染者中大多数 HIV 相关恶性肿瘤的发病年龄更早，且与非 HIV 相关恶性肿瘤相比，病程更具侵袭性。了解常见的 HIV 相关恶性肿瘤及其特定的影像学特征对于做出准确和早期诊断至关重要，因为这会影响治疗。由于 HIV 感染者免疫系统较弱，这些患者中还普遍存在其他实体，如各种感染，特别是机会性感染。这些过程可能会产生与恶性肿瘤相似的混淆临床和影像学表现。本文回顾了最常见的 AIDS 定义性和非 AIDS 定义性恶性肿瘤、影像学在其诊断中的作用，以及 HIV 感染者中恶性肿瘤的影像学模拟。RSNA，2018 年。
