title: [A fistula between the rectosigmoid junction and the ileum as a complication of highly malignant AIDS-associated lymphoma].
abstract: A 29-year-old man, a known heroin addict until 1984 in whom HIV antibodies had been first demonstrated in 1985, was hospitalized because of fever, nocturnal sweating, weight loss and treatment-resistant diarrhoea. An opportunistic infection of the gastrointestinal tract was excluded microbiologically and serologically. Coloscopy and biopsy revealed a highly malignant gastrointestinal B-cell lymphoma, which had caused a spontaneous rectosigmoid-ileum fistula. Lymphoma infiltrations were also found in the duodenum, jejunum, left lung and brain. Because the underlying disease was far progressed (CD4/CD8 ratio: 0.04) and the patient was in a poor general condition neither surgery nor chemotherapy was undertaken. He died of cerebral lymphoma involvement. Gastrointestinal lymphoma should be included in the differential diagnosis of chronic diarrhoea in HIV-positive patients.
authors.affiliation: Abteilung Innere Medizin I, Universität Tübingen.
authors.forename: B
authors.initials: B
authors.lastname: Bruck
authors.forename: S
authors.initials: S
authors.lastname: Dette
authors.forename: E
authors.initials: E
authors.lastname: Kaiserling
authors.forename: M
authors.initials: M
authors.lastname: Scheurlen
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000473:pathology; D000328:Adult; D003937:Diagnosis, Differential; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D006556:Heroin Dependence / Q000150:complications; D006801:Humans; D007077:Ileal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D007412:Intestinal Fistula / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D016483:Lymphoma, AIDS-Related / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D009362:Neoplasm Metastasis; D012002:Rectal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D012810:Sigmoid Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology
vernacular_title: Fistel zwischen rektosigmoidalem Ubergang und Ileum als Komplikation eines AIDS-assoziierten hochmalignen Lymphoms.