Pan Lin, Shao Huaguo
Department of Ultrasound, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Institute of Hepatology and Epidemiology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Med (Lausanne). 2023 Dec 11;10:1243599. doi: 10.3389/fmed.2023.1243599. eCollection 2023.
This study aimed at exploring the ultrasound characteristics of superficial lymph nodes (LNs) in HIV patients with infection to provide assistance and understanding for diagnosis and therapy.
A retrospective analysis was conducted on 26 patients with confirmed HIV and coinfection. These patients underwent ultrasound examination and ultrasound-guided puncture biopsies at our hospital from March 2015 to March 2023.
In all 26 patients, lymphadenectasis was observed. Among the 21 cases (80.76%), LNs showed a diffusely hyperechoic appearance with a tulle-like change, and 6 cases (23.07%) showed liquefaction. When the hila were present or thinned, the blood flow signals were primarily hilar, whether rich or poor, and when the hila were absent, the blood flow signals were peripheral or poor. The axillary LN long-to-short diameter (L/S) ratios exhibited a significant positive correlation with CD4T cell counts ( = 0.8214, = 0.0341). Patients with retroperitoneal lymphadenectasis showed decreased NK cell counts ( = 0.03).
In summary, the infection of LNs in HIV patients often manifests with superficial LN enlargement, mostly affecting the cervical LNs. The -infected LNs exhibit several characteristics such as echogenicity, hilum, and blood flow signal. Furthermore, there might be associations between lymphocyte subsets and enlarged superficial LNs. Ultrasound examinations should be paid attention to if patients have superficial LN enlargement, and the diagnosis of the infection is considered.
本研究旨在探讨合并感染的HIV患者浅表淋巴结(LN)的超声特征,为诊断和治疗提供帮助与认识。
对26例确诊为HIV且合并感染的患者进行回顾性分析。这些患者于2015年3月至2023年3月在我院接受了超声检查及超声引导下穿刺活检。
26例患者均观察到淋巴结肿大。21例(80.76%)淋巴结表现为弥漫性高回声,呈网眼状改变,6例(23.07%)出现液化。当存在或变细的淋巴结门时,血流信号主要位于淋巴结门,无论丰富与否,而当无淋巴结门时,血流信号为周边型或稀少。腋窝淋巴结纵横径(L/S)比值与CD4T细胞计数呈显著正相关(r = 0.8214,P = 0.0341)。腹膜后淋巴结肿大的患者自然杀伤细胞计数降低(P = 0.03)。
总之,HIV患者淋巴结感染常表现为浅表淋巴结肿大,主要累及颈部淋巴结。感染的淋巴结呈现出如回声性、淋巴结门和血流信号等多种特征。此外,淋巴细胞亚群与浅表淋巴结肿大之间可能存在关联。如果患者出现浅表淋巴结肿大,应重视超声检查,并考虑感染的诊断。