病理学的に眼瞼カポジ肉腫と診断できたHIV感染症の1例

Histopathologically diagnosed Kaposi sarcoma of the eyelid in a case infected by human immunodeficiency virus（HIV）

要約　目的：組織学的に眼瞼のカポジ肉腫と診断できたAIDS患者の報告。症例：43歳男性がアメーバ性肝膿瘍を契機として，ヒト免疫不全ウイルス（HIV）抗体が陽性であることが判明し，精査のため眼科を受診した。所見と経過：頸部と鼠径部にリンパ節腫大があり，生検でカポジ肉腫と診断された。薬物投与でリンパ節腫大は消退した。初診から2か月後に右の下眼瞼に暗赤色腫瘍が生じ，薬物療法に反応しないためその4か月後に全摘出した。大きさは14×12mmで，病理学的にHHV-8の潜伏感染タンパクが検出され，カポジ肉腫と診断された。以後9か月間，眼瞼腫瘍の再発はない。結論：薬物療法で軽快しない眼瞼のカポジ肉腫に対し，生検を兼ねた切除は有効であった。

Abstract.　Purpose：To report a case of AIDS with Kaposi sarcoma in the eyelid. Case：A 43-year-old male was referred to us after he was found to be positive for antibody to human immunodeficiency virus（HIV）following amoebic liver abscess. Findings：He had swelling of lymph nodes in the neck and unguinal region. Biopsy led to the diagnosis Kaposi sarcoma. Lymph node swelling subsided after medication. A dark red tumor developed in the right lower eyelid 2 months after his initial visit. It failed to respond to treatment and was resected 4 months later. Its size was 14mm by 12mm. The tumor contained HHV-8 latency-associated nuclear antigen in the nucleus and was diagnosed with Kaposi sarcoma. He has been doing well during 9 months until present. Conclusion：Total excision with pathological examinations was effective for Kaposi sarcoma in the eyelid that failed to respond to medical treatment.