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HIV-Associated Kaposi's Sarcoma.

机译：艾滋病毒相关的卡波济氏肉瘤。

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A 25-year-old man was diagnosed with HIV infection and a CD4 count of 21/mul. He presented with chills, fever up to 39.5 degrees C and dry cough since 1 week. Antibiotic treatment for suspected pneumonia resulted in some clinical improvement. He had a blackish spot on his right forearm, which slowly evolved into a firm nodule (panel A), and a small purple spot on the hard palate. Both were interpreted as Kaposi's sarcoma (KS). Endoscopy revealed no gastrointestinal or pulmonary lesions. Human herpes virus 8 (HHV8) IgG EIA was negative both initially and after starting highly active antiretroviral therapy (HAART). Despite an increase of CD4 to 207/mul, the oral nodule evolved into a prominent tumor of 2.5x2.5 cm (panel B). Biopsy confirmed KS, showing irregular vascular spaces, prominent endothelium, extravasated erythrocytes, and atypical spindle cells positive for CD31, CD34 and HHV8 (panel C). Several weeks later, the patient developed increasing dyspnea; a CT scan revealed perihilar, radially configured pulmonary infiltrates predominantly of the left lower lobe (panel D), consistent with pulmonary KS.HIV-associated KS affects the skin and/or mucous membranes and is strictly associated with HHV8 coinfection. However, HHV8 serology may be unreliable especially in the setting of severe immunodeficiency. Usually, immune reconstitution with HAART leads to resolution of KS, but in some cases chemotherapy may be necessary.Treatment with liposomal doxorubicin led to rapid improvement of his dyspnea, weight gain of 3 kg within 6 weeks, and complete flattening of the lesion on the palate within 9 weeks.
机译：一名25岁的男子被诊断出感染了HIV，CD4计数为21 / mul。自1周以来，他表现出畏寒，发烧至39.5摄氏度和干咳。疑似肺炎的抗生素治疗导致了一些临床改善。他的右前臂上有一个黑色的斑点，逐渐演变成结节状结节（图A），硬the上有一个小的紫色斑点。两者均被解释为卡波济氏肉瘤（KS）。内窥镜检查未发现胃肠道或肺部病变。人疱疹病毒8（HHV8）IgG EIA最初和开始进行高活性抗逆转录病毒治疗（HAART）后均为阴性。尽管CD4增加到207 / mul，但口腔结节仍演变为2.5x2.5 cm的突出肿瘤（图B）。活检证实为KS，显示出不规则的血管间隙，突出的内皮，外渗的红细胞和对CD31，CD34和HHV8阳性的非典型梭形细胞（图C）。几周后，患者出现呼吸困难加重。 CT扫描显示肺叶周围呈放射状的肺周围浸润，主要是左下叶（图D），与肺部KS一致。与HIV相关的KS影响皮肤和/或粘膜，并与HHV8合并感染密切相关。但是，HHV8血清学检查可能不可靠，尤其是在严重免疫缺陷的情况下。通常，用HAART进行免疫重建可导致KS消退，但在某些情况下可能需要化学疗法。阿霉素脂质体治疗可导致呼吸困难迅速改善，6周内体重增加3 kg，并使病灶完全扁平化在9周内化。

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