Abdominal CT in acquired immunodeficiency syndrome.
Acquired immunodeficiency syndrome (AIDS) is a lethal infectious disease that has reached epidemic proportions in urban centers of the United States. Intraabdominal opportunistic infections and malignancies are common features of this syndrome. A prodromal phase or possibly milder form of infection is known as the AIDS-related complex. Abdominal computed tomography (CT) in patients with AIDS-related complex often demonstrates a triad of mild retroperitoneal and mesenteric adenopathy, splenomegaly, and perirectal inflammation. Lymph node enlargement greater than 1.5 cm is unusual in the AIDS-related complex and should prompt CT-guided biopsy. Abdominal adenopathy (greater than 1.5 cm) in AIDS, in our experience, is most commonly related to non-Hodgkin lymphoma, Kaposi sarcoma, or infection with Mycobacterium avium-intracellulare. In most instances, CT-guided biopsy with appropriate staining technique can readily distinguish these entities. However, the subtyping of non-Hodgkin lymphoma by fine-needle aspiration biopsy alone remains controversial. Unusual features of abdominal malignancies are common in AIDS. These include a purely lymphadenopathic form of AIDS-related Kaposi sarcoma and a predilection for extranodal sites of lymphoma in AIDS. In general, patients with AIDS-related lymphoma present with advanced stages of disease with highly malignant histologic subtypes. Abdominal CT may be useful clinically for diagnosing intraabdominal complications of AIDS.
D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging* / Q000209:etiology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000000981:diagnostic imaging*; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D007239:Infections / Q000000981:diagnostic imaging / Q000209:etiology; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D008223:Lymphoma / Q000000981:diagnostic imaging* / Q000209:etiology; D011860:Radiography, Abdominal; D012514:Sarcoma, Kaposi / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed