Fouret P J, Touboul J L, Mayaud C M, Akoun G M, Roland J
Thorax. 1987 Apr;42(4):262-8. doi: 10.1136/thx.42.4.262.
Pulmonary Kaposi's sarcoma may contribute to respiratory dysfunction in patients with acquired immune deficiency syndrome (AIDS) and features of pneumonitis. Opportunistic infections are readily recognised in endoscopic material, but pulmonary Kaposi's sarcoma is easily missed, so that patients are deprived of specific treatment. The clinical and pathological findings from nine cases of pulmonary Kaposi's sarcoma have been reviewed; these were found among 84 patients with AIDS and pneumonitis undergoing fibreoptic bronchoscopy and bronchoalveolar lavage. Diagnosis was established before death in eight patients (in five by bronchial biopsy and in three by open lung biopsy). Examination of lavage fluid showed alveolar haemorrhage in six patients. It is concluded that: (1) fibreoptic bronchoscopy may be useful in the diagnosis of endobronchial lesions of Kaposi's sarcoma; (2) alveolar haemorrhage in patients with AIDS is suggestive of pulmonary Kaposi's sarcoma. Factors that may cause difficulties in diagnosis include the focal nature of some lesions and the pleural or parenchymatous location of others. In addition, in the lung as in the skin, the early stages of Kaposi's sarcoma resemble granulation tissue. Such lesions are far more difficult to recognise than is the late nodular stage.
肺卡波西肉瘤可能导致获得性免疫缺陷综合征（AIDS）患者出现呼吸功能障碍及肺炎特征。在内镜检查材料中，机会性感染很容易被识别，但肺卡波西肉瘤很容易被漏诊，从而使患者得不到特异性治疗。回顾了9例肺卡波西肉瘤的临床和病理表现；这些病例来自84例接受纤维支气管镜检查和支气管肺泡灌洗的AIDS合并肺炎患者。8例患者在死亡前确诊（5例通过支气管活检，3例通过开胸肺活检）。对灌洗液的检查显示6例患者有肺泡出血。得出以下结论：（1）纤维支气管镜检查可能有助于诊断卡波西肉瘤的支气管内病变；（2）AIDS患者的肺泡出血提示肺卡波西肉瘤。可能导致诊断困难的因素包括一些病变的局灶性以及其他病变位于胸膜或实质内。此外，与皮肤一样，肺内卡波西肉瘤的早期阶段类似肉芽组织。这类病变比晚期结节阶段更难识别。
