González-López A, Fernández-Martín J I, Gordillo I, Dronda F
Unidad de Enfermedades Infecciosas-Microbiología, Hospital General Penitenciario, Madrid.
Med Clin (Barc). 1996 Apr 27;106(16):622-3.
Kaposi sarcoma (KS) is the most frequent neoplasm found in AIDS patients. The disease is often disseminated and preferentially involves the skin and the lymphatic and digestive systems. Hepatosplenic involvement which is considered as a frequent autopsy finding is rarely diagnosed at life. A 27-year-old male HIV positive patient with severe immunosuppression who developed a rapidly progressive laterocervical cutaneous KS confirmed by pathologic study is presented. Abdominal echography and thoracoabdominal CT scand demonstrated lesions highly suggestive of pulmonary, lymph node, hepatic, splenic and rectal involvement by KS. The administration of 2 chemotherapy cycles produced subjective improvement and remission of the cutaneous lesions. Severe pulmonary superinfection led to death. An autopsy study was not performed. Hepatosplenic involvement by KS, diagnosed while the patient is alive is rare. The imaging techniques are useful to diagnose with high probability visceral involvement of KS. Systemic searching for visceral involvement in KS patients would lead to a marked increase in the cases such as that herein described with evident therapeutic and prognostic implications.
卡波西肉瘤(KS)是艾滋病患者中最常见的肿瘤。该疾病常呈播散性,且优先累及皮肤以及淋巴和消化系统。肝脾受累在尸检中虽被视为常见发现,但生前很少被诊断出来。本文介绍了一名27岁的男性HIV阳性患者,该患者有严重免疫抑制,经病理研究证实患了快速进展的颈侧皮肤KS。腹部超声检查和胸腹部CT扫描显示有病变,强烈提示KS累及肺、淋巴结、肝、脾和直肠。进行了2个化疗周期后,患者主观症状改善,皮肤病变缓解。严重的肺部重叠感染导致患者死亡。未进行尸检研究。KS累及肝脾在患者生前被诊断出来的情况很罕见。影像学技术有助于高度疑似诊断KS的内脏受累情况。对KS患者进行系统性的内脏受累检查,将会使本文所述这类病例显著增加,具有明显的治疗和预后意义。