Diagnostic imaging of gastrointestinal lesions complicating AIDS

Abstract

Objective: To investigate the findings about gastrointestinal lesions in patients with HIV/AIDS by diagnostic imaging.Methods: The findings about gastrointestinal lesions by diagnostic imaging in 11 patients with HIV/AIDS were retrospectively analyzed. Plain chest radiography was performed for all the 11 cases, but chest CT scanning for 4 cases, abdominal CT scanning for 9 cases, pelvic CT scanning for 2 cases, pelvic MR imaging for 1 case, and gastrointestinal endoscopy for 9 cases. Results: Gastrointestinal perforation was shown in 3 cases, including 2 cases of esophageal perforation and 1 case of gastric perforation. Intestinal tuberculosis was diagnosed in 2 cases, cytomegalovirus enteritis in 1 case, lymphoma in 4 cases, and gastric adenocarcinoma in 1 case. Esophageal perforation was shown together with mediastinal esophageal fistula, mediastinal lymph nodes tuberculosis and pulmonary tuberculosis. Gastric perforation was shown with gastric fistula, left lobe hepatic abscess and hepatogastric space abscess. Intestinal tuberculosis was shown with thickened ileocecal wall, while cytomegalovirus colitis was indicated by central thickening of rectum wall and the end-piece of sigmoid colon. Lymphoma was indicated by tumor-like thickening of gastrointestinal wall, luminal stenosis or dilatation, with accompanying ulceration and enlarged peripheral lymph nodes. Gastric adenocarcinoma was demonstrated with thickening and stiffness of gastric wall, with significant enhancement by contrast imaging/scanning. Conclusion: Gastrointestinal lesions in patients with HIV/AIDS may indicate a variety of opportunistic infections and malignancies, and radiological modalities contribute to the diagnosis of these lesions.