Aboulafia A J, Khan F, Pankowsky D, Aboulafia D M
Department of Orthopaedic Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Am J Orthop (Belle Mead NJ). 1998 Feb;27(2):128-34.
Although musculoskeletal lesions are not reported as commonly as pulmonary or central nervous system abnormalities in human immunodeficiency virus (HIV)-positive individuals, a wide variety of osseous and soft-tissue changes are seen in these patients. We describe the case of a 35-year-old injection drug user with acquired immune deficiency syndrome (AIDS) who presented with diffuse adenopathy, lower extremity pain and swelling, subcutaneous nodules, and constitutional symptoms. Radiographic images showed bilateral lytic lesions of the tibia and accompanying soft-tissue masses. Biopsy of the bone and soft-tissue abnormalities established a diagnosis of Burkitt's-like non-Hodgkin's lymphoma (NHL). By recognizing the heterogeneity of AIDS-associated NHL presentations, and the potential clinical overlap between malignancy, infection, and other rheumatologic abnormalities, physicians may obtain appropriate diagnostic studies and offer treatment recommendations.
尽管在人类免疫缺陷病毒(HIV)阳性个体中,肌肉骨骼病变的报告不如肺部或中枢神经系统异常那么常见,但在这些患者中可见到各种各样的骨骼和软组织变化。我们描述了一名35岁的获得性免疫缺陷综合征(AIDS)注射吸毒者的病例,该患者出现弥漫性淋巴结病、下肢疼痛和肿胀、皮下结节以及全身症状。影像学图像显示双侧胫骨溶骨性病变及伴随的软组织肿块。对骨骼和软组织异常进行活检确诊为伯基特样非霍奇金淋巴瘤(NHL)。通过认识到艾滋病相关NHL表现的异质性,以及恶性肿瘤、感染和其他风湿性异常之间潜在的临床重叠,医生可以进行适当的诊断研究并提供治疗建议。