Abdominal CT in acquired immunodeficiency syndrome

Area of Science:

• Radiology
• Infectious Diseases
• Oncology

Background:

• Acquired Immunodeficiency Syndrome (AIDS) presents significant challenges with intra-abdominal infections and malignancies.
• AIDS-related complex (ARC) is a milder form or prodrome of AIDS, often showing specific abdominal CT findings.
• Abdominal CT is vital for diagnosing intra-abdominal complications in patients with AIDS.

Purpose of the Study:

• To highlight the role of abdominal computed tomography (CT) in diagnosing intra-abdominal complications in patients with AIDS and AIDS-related complex.
• To describe characteristic CT findings in ARC and differentiate them from more advanced AIDS.
• To discuss common and unusual intra-abdominal malignancies and infections in AIDS patients.

Main Methods:

• Review of abdominal CT findings in patients with AIDS and ARC.
• Correlation of imaging findings with histopathological diagnoses.
• Emphasis on lymph node size criteria for guiding biopsy decisions.

Main Results:

• ARC often shows mild retroperitoneal/mesenteric adenopathy, splenomegaly, and perirectal inflammation on CT.
• Lymphadenopathy >1.5 cm in AIDS is suspicious and commonly represents non-Hodgkin lymphoma, Kaposi sarcoma, or Mycobacterium avium-intracellulare infection.
• CT-guided biopsy with staining effectively distinguishes these entities, though lymphoma subtyping can be challenging.
• AIDS-related malignancies exhibit unusual presentations, including lymphadenopathic Kaposi sarcoma and extranodal lymphoma.

Conclusions:

• Abdominal CT is a valuable tool for detecting and characterizing intra-abdominal complications in AIDS.
• Specific CT findings can suggest ARC, prompting further investigation.
• Enlarged abdominal lymphadenopathy in AIDS warrants biopsy to identify underlying lymphoma, Kaposi sarcoma, or infection.