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感染人类免疫缺陷病毒患者的鼻窦非霍奇金淋巴瘤:三例报告及文献复习

Sinonasal non-Hodgkin's lymphoma in patients infected with human immunodeficiency virus: report of three cases and review.

作者信息

Pomilla P V, Morris A B, Jaworek A

机构信息

Department of Medicine, Baystate Medical Center, Springfield, Massachusetts 01199, USA.

出版信息

Clin Infect Dis. 1995 Jul;21(1):137-49. doi: 10.1093/clinids/21.1.137.

Abstract

Non-Hodgkin's lymphoma (NHL) is a frequent complication of human immunodeficiency virus (HIV) infection, but involvement of the sinonasal region has only rarely been reported. We report three cases of AIDS-associated sinonasal NHL that occurred at our institution and review eight cases that were reported in the literature. The epidemiological and clinicopathologic features of these cases are described and compared with those of three other groups of patients: non-HIV-infected patients with sinonasal NHL, HIV-infected patients with NHL of any anatomic site, and HIV-infected patients with infectious sinusitis. Patients with AIDS-associated sinonasal NHL more frequently developed bony erosion and presented with signs and symptoms referable to adjacent structures, such as the orbit, than did HIV-infected patients with sinusitis, and patients with AIDS and NHL less frequently had typical sinus symptoms and diffuse sinus involvement than did patients with sinusitis. However, the clinical manifestations of these conditions overlap; thus a high index of suspicion for NHL is imperative for prompt diagnosis. These lymphomas typically are high-grade and disseminate early, and the prognosis is generally poor.

摘要

非霍奇金淋巴瘤(NHL)是人类免疫缺陷病毒(HIV)感染常见的并发症,但鼻窦区域受累的情况鲜有报道。我们报告了在本机构发生的3例艾滋病相关鼻窦NHL病例,并回顾了文献中报道的8例病例。描述了这些病例的流行病学和临床病理特征,并与其他三组患者进行了比较:非HIV感染的鼻窦NHL患者、任何解剖部位发生NHL的HIV感染患者以及患有感染性鼻窦炎的HIV感染患者。与患有鼻窦炎的HIV感染患者相比,艾滋病相关鼻窦NHL患者更常出现骨质侵蚀,并表现出与相邻结构(如眼眶)相关的体征和症状,且艾滋病合并NHL患者比鼻窦炎患者更少出现典型的鼻窦症状和弥漫性鼻窦受累。然而,这些疾病的临床表现存在重叠;因此,高度怀疑NHL对于及时诊断至关重要。这些淋巴瘤通常为高级别且早期播散,预后一般较差。

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