Radin D R, Esplin J A, Levine A M, Ralls P W
Department of Radiology, University of Southern California School of Medicine, L.A. County-USC Medical Center 90033-1084.
AJR Am J Roentgenol. 1993 May;160(5):1133-9. doi: 10.2214/ajr.160.5.8470595.
Non-Hodgkin's lymphoma is a common complication in patients with HIV infection. The purpose of this study was to analyze the abdominal CT findings in a large series of patients with this condition.
We retrospectively reviewed the abdominal CT examinations of 110 men and two women (21-62 years old; average, 39 years) with untreated AIDS-related lymphoma, as defined by the Centers for Disease Control. Lymphoma was the initial AIDS-defining illness in 79% of the patients.
Abdominal CT scans showed normal findings or only mild enlargement of the liver or spleen in 36% of the 112 patients, whereas evidence of intraabdominal lymphoma was seen in 64%. Evidence of focal lymphomatous involvement was seen on abdominal CT scans in 58 (98%) of 59 patients in whom the predominant signs and symptoms were related to the abdomen and in 14 (26%) of 53 patients with extraabdominal signs or symptoms. In the 64% of patients with evidence of intraabdominal lymphoma, lymph node enlargement was seen in 56% and extranodal disease was seen in 86%. Extranodal sites of involvement in the 72 patients with evidence of intraabdominal lymphoma included the gastrointestinal tract (54%), liver (29%), kidney (11%), adrenal gland (11%), lower genitourinary tract (10%), spleen (7%), peritoneum and omentum (7%), pancreas (5%), epidural space (4%), bone (3%), and muscle (1%). Mild enlargement of the liver or spleen was present in a minority of cases. Moderate or marked hepatomegaly (cephalocaudal span > 20 cm) and splenomegaly (cephalocaudal span > 15 cm) were even less common and occurred only in the presence of focal hepatic lesions.
Our results show that AIDS-related lymphoma may affect any abdominal organ, most commonly lymph nodes, the gastrointestinal tract, liver, kidney, and adrenal gland. Hepatic or splenic enlargement was uncommon and was not often seen as an isolated finding in the absence of evidence of abdominal lymphoma.
非霍奇金淋巴瘤是HIV感染患者的常见并发症。本研究的目的是分析大量患有这种疾病的患者的腹部CT表现。
我们回顾性分析了110名男性和2名女性（21 - 62岁；平均39岁）未经治疗的艾滋病相关淋巴瘤患者的腹部CT检查结果，这些患者由疾病控制中心定义。淋巴瘤是79%患者最初的艾滋病定义疾病。
112例患者中，36%的腹部CT扫描显示正常或仅肝脏或脾脏轻度肿大，而64%可见腹内淋巴瘤证据。59例主要体征和症状与腹部相关的患者中，58例（98%）腹部CT扫描可见局灶性淋巴瘤累及证据；53例有腹外体征或症状的患者中，14例（26%）可见。在64%有腹内淋巴瘤证据的患者中，56%可见淋巴结肿大，86%可见结外病变。72例有腹内淋巴瘤证据的患者的结外受累部位包括胃肠道（54%）、肝脏（29%）、肾脏（11%）、肾上腺（11%）、下泌尿生殖道（10%）、脾脏（7%）、腹膜和网膜（7%）、胰腺（5%）、硬膜外间隙（4%）、骨骼（3%）和肌肉（1%）。少数病例有肝脏或脾脏轻度肿大。中度或显著肝肿大（头足径>20 cm）和脾肿大（头足径>15 cm）更少见，仅在存在局灶性肝脏病变时出现。
我们的结果表明，艾滋病相关淋巴瘤可能累及任何腹部器官，最常见的是淋巴结、胃肠道、肝脏、肾脏和肾上腺。肝脏或脾脏肿大不常见，在没有腹内淋巴瘤证据时很少单独出现。
