扩散大B细胞淋巴瘤和胃肠道卡波西肉瘤:一种罕见的上部胃肠道出血的原因
Carmen Amor Costa1, Joaquín Fisac Vázquez2, María Dolores Martín-Arranz1
1Aparato Digestivo, Hospital Universitario La Paz, España.
Revista espanola de enfermedades digestivas
|October 26, 2023
概括
本案例研究突出了一个罕见的上部胃肠道出血的例子,在HIV阳性患者由于卡波西肉瘤和扩散大B细胞淋巴瘤. 内镜活检证实了这些诊断,强调了免疫功能受损的个体需要保持警.
科学领域:
- 在瘤学瘤学.
- 病毒学 病毒学
- 胃肠病学 胃肠病学
背景情况:
- 人类免疫缺陷病毒 (HIV) 感染可能导致先进的免疫抑制.
- 爱斯坦-巴尔病毒 (EBV),细胞巨化病毒 (CMV),卡波西肉瘤 (KS) 和扩散型大B细胞淋巴瘤 (DLBCL) 是与HIV相关的机会性感染和恶性瘤.
- 上部胃肠道出血是KS和DLBCL的不常见表现.
研究的目的:
- 报告一种罕见的胃肠道上部出血病例,该病例是由HIV阳性患者同时患有卡波西肉瘤和爱斯坦-巴尔病毒相关的扩散性大B细胞淋巴瘤引起的.
- 为了说明上部胃肠道中这些疾病的内镜检测结果和诊断过程.
主要方法:
- 一个49岁的艾滋病毒感染的男性患者的病例报告,先进的免疫抑制和抗逆转录病毒治疗的启动.
- 诊断的扩散大B细胞淋巴瘤 (DLBCL) 与爱斯坦-巴尔病毒 (EBV),传播型细胞巨核病毒 (CMV) 感染,以及皮肤卡波西肉瘤 (KS).
- 由于黑斑和贫血化,进行了紧急的胃镜检查,揭示了胃和十二指肠的特征性病变. 为了进行基因病理学分析,获得了活检.
主要成果:
- 胃镜检查显示了多种红血性,胃中亚皮质起源的升高病变,有些有中心或的表面. 在十二指管球和第二部分观察到类似的大,紫色的,性病变.
- 解剖病理学诊断证实了十二指肠病变中的卡波西肉瘤 (KS) 以及胃病变中的KS和EBV相关的DLBCL.
- 患者出现了上部胃肠道出血,这是这些病理的特殊表现.
结论:
- 卡波西肉瘤通常会影响艾滋病毒患者的胃肠道,胃是最常见的部位,通常以结节性病变的形式呈现.
- 扩散性大B细胞淋巴瘤 (DLBCL) 经常涉及胃作为外节瘤参与的地点.
- 上部胃肠道出血是一种罕见但关键的同时发生的KS和EBV相关的DLBCL的表现,需要内镜活检才能确定诊断.
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