巨细胞病毒性肺炎中氯化铊-201的双侧肺弥漫性摄取。病例报告及组织病理学相关性分析

Diffuse bilateral lung uptake of TI-201 chloride in CMV pneumonitis. Case presentation with histopathologic correlation.

作者信息

Bag R, Tambouret G R, Kempf J, Habbab N, Sadik A, Difabrizio L, Abdel-Dayem H M

机构信息

Department of Radiology, St. Vincent's Hospital and Medical Center of New York, NY 10011, USA.

出版信息

Clin Nucl Med. 1995 Jun;20(6):538-41. doi: 10.1097/00003072-199506000-00017.

DOI:10.1097/00003072-199506000-00017

PMID:7648742

Abstract

Diffuse intense lung uptake of TI-201 chloride without abnormal Ga-67 citrate in a case of cytomegalovirus pneumonitis in a patient with AIDS is presented. An autopsy performed within 4 days of imaging revealed no pulmonary pathology other than diffuse cytomegalovirus infection with abundant histiocytes and inclusion bodies and pulmonary congestive heart failure. Among the various mechanisms of TI-201 accumulation, active transport through Na-K ATPase appears to be predominant in this case, as suggested by innumerable histiocytes. It is the authors' experience that positive TI-201 uptake without abnormal Ga-67 accumulation is highly specific for pulmonary Kaposi sarcoma. The presence of such discrepancy between TI-201 and Ga-67 uptake in AIDS patients decreases the specificity of a TI-201 positive/Ga-67 negative lesion for pulmonary Kaposi sarcoma, especially with the rising incidence of both cytomegalovirus and Kaposi sarcoma in AIDS patients.

摘要

本文报道了1例艾滋病患者巨细胞病毒性肺炎，其表现为氯化铊（TI-201）在肺内弥漫性浓聚，而枸橼酸镓（Ga-67）无异常摄取。成像后4天内进行的尸检显示，除弥漫性巨细胞病毒感染伴大量组织细胞和包涵体以及肺充血性心力衰竭外，无其他肺部病变。在TI-201蓄积的各种机制中，通过钠钾ATP酶的主动转运在该病例中似乎占主导地位，无数组织细胞提示了这一点。作者的经验是，TI-201摄取阳性而Ga-67无异常蓄积对肺卡波西肉瘤具有高度特异性。艾滋病患者中TI-201和Ga-67摄取之间存在这种差异，降低了TI-201阳性/Ga-67阴性病变对肺卡波西肉瘤的特异性，尤其是在艾滋病患者中巨细胞病毒和卡波西肉瘤发病率均上升的情况下。