Diagnosis of Tumor in Gastrointestinal Tract Relative to Immunological Disorder: Especially, Aim to Early Detection of AIDS Related Malignant Tumors Yoshiro Tamegai 1 , Hiroko Serizawa 1 , Naoyoshi Nagata 1 1Department of Gastroenterology, International Medical Center of Japan Keyword: HIV , AIDS , Kaposi肉腫 , 悪性リンパ腫 , 拡大内視鏡 pp.1117-1133
Published Date 2005/7/25
DOI https://doi.org/10.11477/mf.1403100136
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 The number of AIDS patients infected with HIV is on the increase. The rate of malignant tumors in the gastrointestinal tract accompanied with HIV infection is so high that early diagnosis is necessary. In this study, 120 upper gastrointestinal endoscopies (male : 111 patients, female : 9 patients, average age : 40.2 years old) and 63 colonoscopies (male : 59 patients, female : 4 patients, average age : 39.8 years old) were performed and 11 Kaposi's sarcomas, 7 malignant lymphomas and 3 colon cancers were detected. We examined endoscopical characteristic images and differential diagnosis in the above mentioned lesions. As a result, in case of Kaposi's sarcomas, a blood blister or imbricate pattern with bright redness was recognized. In contrast, in case of malignant lymphoma, slight redness was observed. Each endoscopic finding showed various morphologies and some of the malignant lymphomas indicated much larger protruded types or depressed types. With magnifying endoscopy, minute lesions of Kaposi's sarcomas showed reddish surface mucosa, swelling intestinal villi, sparse type I pit pattern, disappearance pit pattern in erosion and redness of the mucosa with a clear boundary. In contrast, in malignant lymphoma, though minute pit pattern was observed, surface mucosa was normal or light red and the border of redness was unclear. We detected 4 colon cancers which were diagnosed with neoplastic pit pattern. On the other hand, though we encountered candidiasis, CMV infections, amebiasis, HSV infections and MAC infections as infectious diseases related to AIDS, it was possible for us to make a differential diagnosis by full examination of erosion, ulceration or protruded areas by endoscopy (including magnifying endoscopy) in detail. We should recognize that patients infected with HIV are in one of the high risk groups for malignant tumor. Also they need to be examined by screening for early diagnosis with conventional and magnifying endoscopy.

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