艾滋病相关浅表淋巴结马尔尼菲蓝状菌病超声影像分析  

Analysis of Ultrasonography Features of AIDS-related Superficial Lymph Node Caused by Talaromyces Marneffei

作　　者：农云洁 农恒荣 黄小桂 黄裕兰 Nong Yunjie;Nong Hengrong;Huang Xiaogui;Huang Yulan(Department of Ultrasound,Ailiated Infetious Disease Hospital of Nanning,Guengxi Medical University Nanning,Guangxi 530023,China)

机构地区：[1]广西医科大学附属南宁市传染病医院超声医学科,广西南宁市530023

出　　处：《中国超声医学杂志》2021年第4期435-438,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广西南宁市科学研究与技术开发计划项目(No.20143147)。

摘　　要：目的探讨艾滋病相关浅表淋巴结马尔尼菲蓝状菌病(ASLTM)超声影像特点及其临床意义。方法回顾性分析经我院超声介入穿刺活检病理、PAS及D-PAS染色证实为ASLTM的102例患者超声影像学、病理学等临床资料。结果102例ASLTM患者,其中血CD4^(+)T计数<50个/μL 83例(81.37%),浅表淋巴结肿大超声表现为多个(97.06%),边界清楚(91.18%),形态规则(85.29%),长短径比值<2居多(72.55%),内部呈实性低回声(89.22%),门样结构消失(86.27%),内部血流信号稀少(83.33%);淋巴结门样结构消失组患者血CD4^(+)T计数明显低于门样结构变薄组(P<0.001)。结论ASLTM好发于血CD4^(+)T计数<50个/μL的AIDS患者,其超声表现具有一定特征性,门样结构超声改变与血CD4^(+)T降低水平有一定的关联,超声介入穿刺活检有助于确诊。Objective To investigate the ultrasonic image feature and the clinical significance of AIDS-related superficial lymph node caused by Talaromyces marneffei(ASLTM). Methods To retrospectively analyse the ultrasonic image and pathology of 102 ASLTM cases confirmed by ultrasound-guided biopsy of pathology and by PAS stain, D-PAS stain. Results Among 102 cases with ASLTM, The CD4+T lymphocyte counts was less than 50/μL in 83 cases(81.37%). Ultrasonography showed multiple superficial lymphadenectasis(97.06%), clear boundary(91.18%), regular morphology(85.29%), long to short diameter ratio <2(72.55%),The interior was hypoechoic solid(89.22%), the structure of lymph node hilus disappeared(86.27%), and internal color flow signal was rare(83.33%). The CD4^(+)T lymphocyte counts in cases with the structure of lymph node hilus disappeared was significantly lower than that of cases with the structure lymph node hilus thickness thinning(P<0.001). Conclusions ASLTM usually occurs in AIDS patients whose blood CD4^(+)T lymphocyte counts is less than 50/μL, and its ultrasonographic features have certain characteristics. There is a certain correlation between the ultrasonic changes of the structure of lymph node hilus and the decreased level of blood CD4^(+)T lymphocyte counts, and the ultrasound-guided puncture biopsy is helpful for the diagnosis.

关 键 词：艾滋病 马尔尼菲蓝状菌病 浅表淋巴结 超声 活组织检查 病理学 

分 类 号：R445.1[医药卫生—影像医学与核医学] R512.91[医药卫生—诊断学]