Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
MALIGNANT NEOPLASMS: KAPOSI'S SARCOMA, LYMPHOMA, AND OTHER DISEASES WITH SIMILAR RADIOGRAPHIC FEATURES
Radiology of AIDS. Federle MP et al, eds. New York, Raven, p. 107-29, 1988.. Unique Identifier : AIDSLINE ICDB/89655315 Federle MP; Nyberg DA; Hulnick DH; Jeffrey RB Jr; San Francisco General Hosp., San Francisco, CA 94110
Abstract:
The clinical manifestations of both Kaposi's sarcoma (KS) and AIDS-related lymphomas (ARLs) are highly variable and difficult to distinguish from other concurrent illnesses. Fever, weight loss, headache, diarrhea, and malaise are common complaints in many patients (pts) with AIDS, whether or not they have KS or lymphoma. Excluding mucocutaneous lesions, the usual sites of ARL and KS also are similar. Attempting to distinguish these neoplasms may be particularly difficult when they coexist, as ARL and KS demonstrate wide radiographic spectra that often overlap. Pathologic and radiologic findings in AIDS-related malignancies are reviewed, with emphasis on KS and ARL; 40 plain film and computed tomography (CT) images are presented. Approx 95% of AIDS pts with KS have visible cutaneous or oral lesions. Multiple lesions represent multicentric involvement, rather than metastases from a primary. Common sites of involvement in one study included the skin (93%), lymph nodes (72%), lung (52%), GI tract (48%), liver (34%), and spleen (34%). ARL has distinct clinical features compared with lymphomas in the general population. Primary brain lymphoma, small noncleaved lymphoma (Burkitt or non-Burkitt type), and immunoblastic sarcoma diagnosed in pts with laboratory evidence of HIV infection are indicator diseases establishing a diagnosis of AIDS. ARL commonly involves multiple abdominal sites, including lymph nodes, solid visceral organs, and bowel. Because of this, CT is the recommended imaging method of choice for examining the abdomen in AIDS pts. Persistent generalized lymphadenopathy (PGL) associated with or indicative of AIDS-related complex appears to predispose to ARL, as well as other AIDS-related disorders. Initial reports of abdominal CT in pts with PGL have emphasized a characteristic triad of mild lymphadenopathy involving the retroperitoneal, mesenteric or pelvic node chains; splenomegaly; and abnormal soft-tissue infiltration of the rectal wall or perirectal fat. Differential diagnosis, CT of abdominal opportunistic infections in AIDS, and indications for abdominal CT also are discussed. (68 Refs)
Keywords: Abdominal Neoplasms/RADIOGRAPHY Acquired Immunodeficiency Syndrome/COMPLICATIONS/*RADIOGRAPHY AIDS-Related Complex/COMPLICATIONS/*RADIOGRAPHY Human Lymphatic Metastasis Lymphoma/*RADIOGRAPHY Opportunistic Infections/RADIOGRAPHY Sarcoma, Kaposi's/*RADIOGRAPHY Skin Neoplasms/*RADIOGRAPHY Tomography, X-Ray Computed MONOGRAPH REVIEW, TUTORIAL REVIEW
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Important note: Information in this article was accurate in 1989. The state of the art may have changed since the publication date.
