肾移植受者并发Kaposi肉瘤4例报告

Diagnosis and treatment of Kaposi′s sarcoma in renal transplant recipients (Report of 4 cases)

目的:探讨同种异体移植型Kaposi肉瘤的发病率及其诊治。方法:回顾性分析我院773例肾移植受者中4例Kaposi肉瘤的发生情况和诊治经过。结果:肾移植术后Kaposi肉瘤发生率为0.52%,占同期发生的各类肿瘤的36.4%,发生时间分别为移植术后3、7、14和21个月,首发症状为咽喉痛、咽部异物感伴吞咽困难者2例,双下肢对称性多发紫红色斑丘疹并下肢水肿者2例,均经病理检查而确诊;治愈2例。结论:应提高对肾移植受者并发Kaposi肉瘤的认识,术后预防病毒感染,尽早行组织学检查,确诊后应立即减少或停用免疫抑制剂。

Purpose:To probe into incidence and diagnosis and treatment of transplantation associated Kaposi′s sarcoma. Methods:4 cases of Kaposi′s sarcoma, occured in 773 renal transplant recipients, were analysed retrospectively. Results:The incidence of Kaposi′s sarcoma concomitant with renal transplantation was 0.52 %. Kaposi′s sarcoma accounted for 36.4 per cent of all tumors in renal transplant population. The time of onset of Kaposi′s sarcoma after transplantation were 3,7,14,21 months individually. The initial signs were pain and sensation of foreign body of throat accompanied by difficulty in swallowing for 2 cases; symmetrical distributional multiple purple or red maculopapule and edema of lower extremity for other 2 cases. The diagnosis of Kaposi′s sarcoma was made by biopsy. There were 2 cases with a successful cure. Conclusions:The knowledge of Kaposi′s sarcoma concomitant with renal transplantation should be enhanced. It is recommended to protection against viral infection after transplantation, perform pathological examination as early as possible and reduce the dose of immunosuppressive agents or discontinue. Chemical therapy or immunopotentiator should be administered if necessary.