艾滋病合并肺部巨细胞病毒感染的影像学与病理对照

Radiological Findings of Cytomegalovirus Pneumonitis in AIDS Patients with Pathological Correlation

目的:探讨艾滋病合并肺部巨细胞病毒感染的影像学及病理表现。方法:回顾性分析经临床及病理证实的5例艾滋病合并肺部巨细胞病毒感染的影像学资料。5例患者全部行CT扫描,4例行胸部数字化摄影,2例穿刺活检,1例尸检,2例经抗巨细胞病毒治疗后明显好转,将影像学检查结果与病理资料进行对照分析。结果:影像学表现:肺门肿块3例(左侧1例,右侧2例),肺不张2例,肺间质性改变3例,斑片状阴影3例,淋巴结肿大2例。病理结果:HE染色见典型核内包涵体伴炎症反应。结论:艾滋病合并肺部巨细胞病毒感染的影像学表现多样,具有一定特征,但缺乏特异性,需结合巨细胞病毒抗体检测或活检穿刺病理组织分析确诊。

Objective：To study the imaging findings of cytomegalovirus pneumonitis in AIDS patients. Methods：The imaging features of 5 AIDS patients complicated with cytomegalovirus pneumonitis were retrospectively analyzed and correlated with pathology. 5 cases had CT,4 cases had digital radiography （DR） of chest;2 cases had CT guided needle aspiration biopsy of lung and 1 case had autopsy. 2 cases had marked improvement after anti-cytomegalovirus therapy. The imaging materials were correlated with pathology. Results：Of the 5 AIDS patients complicated with eytomegalovirus pneumonitis, there were pulmonary hilar mass （3 cases, 1 in the left and 2 in the right）, atelectasis （2 cases）, interstitial abnormalities （3 cases）, pulmonary patchy opacities （3 cases） and lymphadenopathy （2 cases）. The pathologic findings included typical intranuclear inclusions accompanied with inflammatory changes of lung on HE staining. Conclusion： The imaging findings of AIDS complicated with CMV pneumonitis varied, with certain characteristic yet non-specific features. The final diagnosis depended on the examination of CMV antibody or the histo-pathology features of biopsy.