Philit F, Mornex J F, Dureau G, Chuzel M, Euvrard S, Ecochard D, Brune J
Service de Pneumologie, Hôpital Louis-Pradel, Lyon.
Rev Mal Respir. 1994;11(4):421-3.
The great strides in organ transplantation have been accompanied by some specific pathologies, notably, neoplasia, including Kaposi's sarcoma which occupies the third place in frequency after cutaneous tumours and malignant lymphomas. We report a case of cutaneous Kaposi's sarcoma developing some six months after a cardiac transplant. The modulation of immuno-suppression and treatment with Alpha interferon allowed an initial stabilisation of the cutaneous lesions. However, there were secondary developments of the lesions and, 21 months after the initial presentation, the patient developed a diffuse infiltrating pneumonia leading to death. The autopsy revealed lymphangitis carcinomatosis of Kaposi's sarcoma type. This observation underlines the therapeutic difficulties seen in Kaposi's sarcoma after organ transplantation when there is no alternative to allow a significant reduction or cessation of immuno-suppression.
器官移植取得的巨大进展伴随着一些特定的病理情况,尤其是肿瘤形成,包括卡波西肉瘤,其发病率在皮肤肿瘤和恶性淋巴瘤之后位列第三。我们报告一例心脏移植术后约六个月发生皮肤卡波西肉瘤的病例。免疫抑制的调整及α干扰素治疗使皮肤病变最初得以稳定。然而,病变出现了继发性进展,在初次发病21个月后,患者发展为弥漫性浸润性肺炎并导致死亡。尸检显示为卡波西肉瘤型淋巴管癌病。该病例强调了器官移植后卡波西肉瘤在无法显著减少或停止免疫抑制的情况下所面临的治疗困难。