脾脏“海绵型”:在hiv阳性患者中罕见的高频超声型。

IF 3.4 Q2 Medicine
Tom Heller, Francesco Taccari, Kelvin Rambiki, Tapiwa Kumwenda, Enrico Brunetti, Claudia Wallrauch
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引用次数: 2

摘要

背景:脾脏在感染检查中经常被扫描。低回声脾微脓肿是HIV合并感染患者播散性结核的已知征象。因此,HIV患者的脾脏通常使用高频换能器进行扫描。方法和结果:我们描述了一个网状结节“海绵模式”的脾脏hiv阳性患者霍奇金淋巴瘤。弥散性分布于整个脾脏,可见非常小(1.5-2.0 mm)的低回声病变,呈分支网状结节状分布。病灶部分跟随脾血管,但不完全。对其他患者存储的图像进行回顾,确定了15个以上的病例显示出类似的模式。所有患者均为HIV阳性,几乎所有患者CD4计数均低于200细胞/mm3。7人(44%)被诊断为hhv -8相关疾病,但这种模式与各种潜在的机会性感染有关。讨论与结论:通过与脾脏显微解剖的比较,我们推测我们患者的脾脏白色髓质增生或其他一致性改变,以便在高频超声下更好地看到。伴随的人类疱疹病毒-8感染可能是这种可见的白色牙髓的另一个原因。虽然我们只能推测脾脏“海绵样”的病因,但它需要被认识到,因为它可能被误解为播散性感染的脾脏微脓肿,如严重免疫功能低下患者的结核病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

"Sponge pattern" of the spleen: a rarely described high-frequency ultrasound pattern in HIV-positive patients.

"Sponge pattern" of the spleen: a rarely described high-frequency ultrasound pattern in HIV-positive patients.

"Sponge pattern" of the spleen: a rarely described high-frequency ultrasound pattern in HIV-positive patients.

"Sponge pattern" of the spleen: a rarely described high-frequency ultrasound pattern in HIV-positive patients.

Background: The spleen is frequently scanned in workup of infections. Hypoechoic splenic micro-abscesses are known signs of disseminated tuberculosis in HIV co-infected patients. The spleen of HIV patients is thus often scanned using high-frequency transducers.

Methods and findings: We describe a reticulo-nodular "sponge pattern" in the spleen of an HIV-positive patient with Hodgkin's lymphoma. Disseminated throughout the spleen, very small (1.5-2.0 mm) hypoechoic lesions having a branching reticulo-nodular distribution were seen. The lesions partly, but not entirely, follow splenic vasculature. Review of stored images of other patients identified 15 more cases showing a similar pattern. All patients were HIV positive, almost all with CD4 counts below 200 cells/mm3. Seven (44%) were additionally diagnosed with HHV-8-associated diseases, but the pattern was seen with various underlying opportunistic infections.

Discussion and conclusion: After comparison with spleen microscopic anatomy, we hypothesize that the white pulp of spleens in our patients is hyperplastic or otherwise changed in consistency to be better visible by high-frequency ultrasound. Concomitant human herpesvirus-8 infection may be another cause of this visible white pulp. While we can only speculate about the etiology of the splenic "sponge pattern," it needs to be recognized as it may be misinterpreted as splenic micro-abscesses of disseminated infections, like tuberculosis in severely immune-compromised patients.

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来源期刊
Ultrasound Journal
Ultrasound Journal Health Professions-Radiological and Ultrasound Technology
CiteScore
6.80
自引率
2.90%
发文量
45
审稿时长
22 weeks
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