Pulmonary Kaposi's Sarcoma in a Myasthenia Gravis Patient Receiving Immunosuppressive Agents: A Case Report

接受免疫抑制劑之重症肌無力病人的肺部卡波西氏肉瘤：病例報告

張均輔(Chun-Fu Chang) ； 黃煦晴(Hsu-Ching Huang) ； 葉奕成(Yi-Chen Yeh) ； 邱昭華(Chao-Hua Chiu)

《胸腔醫學》 34卷1期 (2019/02) Pp. 20-27

摘要

Primary pulmonary Kaposi's sarcoma is an uncommon complication in patients receiving immunosuppressive agents and may be difficult to diagnose. We reported a 62-year-old female patient who had received azathioprine and prednisolone for myasthenia gravis for 10 years and was found to have pulmonary Kaposi's sarcoma without cutaneous involvement. The diagnosis based on the presence of typical flame-shaped lesions on chest computed tomography and a typical histopathological finding, with positive immunohistochemical staining for human herpesvirus 8 on lung biopsy specimens. The patient received 2 cycles of systemic chemotherapy with pegylated liposomal doxorubicin. However, bacteremia and cytomegalovirus viremia developed during chemotherapy. The patient ultimately died from respiratory failure 6 months after the diagnosis of Kaposi's sarcoma.

關鍵字

Kaposi's sarcoma ； human herpesvirus 8 ； azathioprine

並列摘要

對於接受免疫抑制劑的病人而言，原發於肺臟的卡波西氏肉瘤是一不常見且不易診斷的併發症。我們報告的這位六十二歲女性因為重症肌無力症在接受免疫抑制治療十年後發生了肺部卡波西氏肉瘤，並且沒有皮膚侵犯。此診斷是以典型的肺部影像學、組織病理學表現和人類疱疹病毒第八型的免疫染色呈現陽性而確立。病患在接受了兩次全身性化學治療之後發生了菌血症和巨細胞病毒感染，並在診斷卡波西氏肉瘤六個月後死於呼吸衰竭。

並列關鍵字

卡波西氏肉瘤 ； 人類疱疹病毒第八型 ； 硫唑嘌呤