ニューモシスチス肺炎合併HIV治療中に肺門部腫瘤影を認めた1例

A case of hilar mass during treatment for pneumocystis pneumonia complicated by human immunodeficiency virus

播種性non-tuberculous mycobacteria（NTM）症は重症免疫不全者に発症する全身性の非結核性抗酸菌症であり，90％以上がMycobacterium avium complex（MAC）を原因菌とする。臨床経過は特徴的であるが多彩な画像所見を呈し，画像のみではしばしば診断に難渋する。今回我々は，Human immunodeficiency virus（HIV）治療中に発症した播種性NTM症を経験したため，若干の文献的考察を加えて報告する。

A 60-year-old male patient had a complaint of dyspnea. He was diagnosed with human immunodeficiency virus（HIV）infection with pneumocystis pneumonia. Highly active antiretroviral therapy was introduced after antimicrobial treatment. Follow-up computed tomography revealed a mass in the right pulmonary hilar region. Additionally, systemic lymphadenitis and thickening of the ascending colon wall were observed. Ascending colon biopsy demonstrated a small number of acid-fast bacilli. The diagnosis was disseminated nontuberculous mycobacterial（NTM）disease. Disseminated NTM disease is known to occur as immune reconstitution inflammatory syndrome in response to HIV treatment.