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患者27岁,男性同性恋者,1993年9月皮肤首次出现多发性紫罗兰色丘疹性病变。此时,其血清HIV阳性已2年。皮肤活检表明为卡波济氏肉瘤(KS)。体检呈现双侧胸腔积液征。胸部X线照片证实体检结果,并发现有弥漫性结节性浸润。胸腔穿刺抽出血性积液,细菌检查阴性。支气管镜检正常。胸部CT扫描显示胸腔积液及弥散性结节性浸润,并发现第11胸椎呈溶化性骨损害。放射性核素骨扫描正常。脊柱磁共振成像(MRI)示第11、12胸椎和第1、2腰椎有结节性损害,用钆注射后,损害灶显示更为清晰。腹部超声检查示腹膜后淋巴结肿
The patient, 27 years old, gay male, developed the first episode of multiple violet-colored papular lesions on the skin in September 1993. At this point, its serum HIV positive for 2 years. Skin biopsy showed Kaposi’s sarcoma (KS). Physical examination showed signs of pleural effusion. Chest radiograph confirmed the physical examination results, and found diffuse nodular infiltration. Thoracentesis hemorrhagic effusion, negative bacterial test. Bronchoscopy is normal. Chest CT scan showed pleural effusion and diffuse nodular infiltration and found that the 11th thoracic spondylolisthesis was benign. Radionuclide bone scan normal. Spinal magnetic resonance imaging (MRI) showed nodular lesions of the thoracic vertebrae 11, 12 and the lumbar vertebrae 1 and 2, and the lesion showed more clearly after injection with gadolinium. Abdominal ultrasound showed retroperitoneal lymph nodes