AIDS-related Intrapulmonary Kaposi's Sarcoma Presenting as Endobronchial Lesions: A Rare Presentation in Taiwan-A Case Report and Literature Review

卡波西氏肉瘤（Kaposis sarcoma）是相當常見的人類免疫缺乏病毒感染之病人併發症之一，最常發生在黏膜表皮處，但是其他部位也有可能會發生。其中若發生在肺內會產生許多呼吸道相關症狀如咳嗽，咳血，運動性氣促等等相關症狀。由於人類免疫缺乏病毒感染相關的肺內併發症如肺囊蟲肺炎，巨細胞病毒肺炎，或是肺結核在國內較為常見，若發生以上所述之症狀時常會疏忽肺內卡波西氏肉瘤的診斷。我們在這裡提出一個人類免疫缺乏病毒感染的病例，由於呼吸道症狀入院，起初以肺結核藥物處理，但是症狀及胸部影像仍然持續惡化。經由典型的電腦斷層及支氣管鏡圖片，懷疑是肺內的卡波西氏肉瘤而進行支氣管鏡檢查及病理切片，切片結果證實我們的憶測。在使用了抗病毒藥物及化學治療後，病人的症狀及胸部影像有顯著且快速的進步。我們也瀏覽了許多的文獻，希望這個經驗可以讓國內的醫師在遇見人類免疫缺乏病毒感染患者罹患呼吸道併發症的同時可以更快速的診斷出卡波西氏肉瘤。

關鍵字

卡波西氏肉瘤；人類免疫缺乏病毒；後天免疫缺乏症候群；肺內併發症

並列摘要

Kaposi's sarcoma (KS) is a complication suffered by patients infected with human immunodeficiency virus (HIV). KS forms most frequently in the mucocutaneous zone, but can also be found in other parts of the body. Intrapulmonary KS may lead to respiratory symptoms, such as coughing, hemoptysis, and exertional dyspnea. Pneumocystic jeroveci pneumonia, cytomegalovirus pneumonia, and pulmonary tuberculosis may be caused by diseases or factors other than intrapulmonary complications of HIV, so the differential diagnosis of intrapulmonary KS could potentially be overlooked. We reported the case of a patient with HIV who was brought to the hospital due to respiratory symptoms. Pulmonary tuberculosis medications were given initially, but the symptoms worsened, and the chest x-ray showed progression of the condition. As a result of computed tomography (CT) and bronchoscopy findings, we further suspected the possibility of intrapulmonary KS. Pathological diagnosis confirmed our impression. With the use of anti-viral medications and chemotherapy, the patient showed improvement in clinical symptoms and chest x-ray findings. We completed an extensive literature review, and believe this experience will help doctors in Taiwan identify KS more quickly when encountering patients with respiratory complications possibly related to HIV.

並列關鍵字

Kaposi's sarcoma ； human immunodeficiency virus (HIV) ； acquired immunodeficiency syndrome (AIDS) ； intrapulmonary complications

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