Skip to main content
SpringerLink
Log in

The spectrum of gastrointestinal radiology in AIDS

  • Gastrointestinal Radiology
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Twohundred and twenty-five adult patients with AIDS were seen at the Academic Medical Center over a 5-year period. Of these patients, 70% were found to have gastrointestinal disease: 32% oropharyngeal candidiasis: 12,5% cytomegalovirus infection, mostly in rectum or colon (5.3%), and 8% mycobacterium.

Kaposi's sarcoma, which has been reported in 27% of the cases in literature, was present in 29%, of our patients.

We had a rather ow incidence of non-Hodgkin lymphoma of the gastrointestinal tract (1,3%). With double-contrast barium studies of the GI tract early superficial mucosal changes can be detected. Endoscopy, especially in Kaposi's sarcoma, may be complementary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Frager DH, Frager JD, Brandt LJ, Wolf EL, Rand LG, Klein RS, Beneventano TC (1986) Gastrointestinal complications of AIDS. Radiologic features. Radiology 158: 597–605

    Google Scholar 

  2. Frager DH, Frager JD, Wolf EL, Rand LG, St Onge G, Mitsudo S, Bodner L, Brandt LJ, Beneventano TC (1986) Cytomegalovirùs colitis in acquired immune deficiency syndrome: Radiologic spectrum. Gastrointest Radiol 11: 241–246

    Google Scholar 

  3. Gottlieb MS, Groopman JE, Weinstein WM, Fahey JL, Detels R (1983) The acquired immunodeficiency syndrome. Ann Intern Med 99: 208–220

    Google Scholar 

  4. Solinger AM, Hess EV (1987) Acquired immune deficiency syndrome — An overview. Semin Roentgenol 22: 9–13

    Google Scholar 

  5. Quinn TC, Stamm WE, Goodell SE, Mkrtichian E, Benedetti J, Corey L, Schuffer MD, Holmer KK (1983) Polymicrobial origin of intestinal infections in homosexual men. N Engl J Med 309: 576–582

    Google Scholar 

  6. Megibow AJ, Wall SD, Balthazar EJ, Rybak BJ (1988) Gastrointestinal radiology in AIDS patients. In: Federle M, Megibow AJ, Naidich DP (eds). Radiology of AIDS. Raven Press, New York, pp 77–105

    Google Scholar 

  7. Wall SD, Ominsky S, Altman DF, Perkins CL, Sollitto R, Goldberg HI, Margulis AR (1986) Multifocal abnormalities of the gastrointestinal tract in AIDS. AJR 146: 1–7

    Google Scholar 

  8. Levine MS, Macones AJ jr, Laufer I (1985) Candida esophagitis: accuracy of radiographic diagnosis. Radiology 154: 581–587

    Google Scholar 

  9. Farman J, Tavitian LE, Rosenthal GE, Schwartz GE, Rautman JP (1986) Focal oesophageal candidiasis in acquired immunodeficiency syndrome (AIDS), Gastrointest Radiol 11: 213–218

    Google Scholar 

  10. Laufer I (1982) Radiology of esophagitis. Radiol Clin North Am 20: 687–699

    Google Scholar 

  11. Levine MS, Woldenberg R, Herlinger H, Laufer I (1987) Opportunistic esophagitis in AIDS: radiographic diagnosis, Radiology 165: 815–820

    Google Scholar 

  12. Levine MS (1989) Radiology of the esophagus. Saunders, New York

    Google Scholar 

  13. Agha FP, Horchang HL, Nostrant TT (1986) Herpetic oesophagitis: a diagnostic challenge in immunocompromised patients. Am J Gastroenterol 81: 246–253

    Google Scholar 

  14. Levine MS, Laufer I, Kressel HY, Friedman H (1981) Herpes esophagitis. AJR 136: 863–866

    Google Scholar 

  15. Shortsleeve MJ, Gauvin GP, Gardner RC, Greenberg MS (1981) Herpetic esophagitis. Radiology 141: 611–617

    Google Scholar 

  16. Skucas J, Schrank WW, Meyers PC, Lee CS (1977) Herpes esophagitis: a case studied by air-contrast esophagography. AJR 128: 497–499

    Google Scholar 

  17. Balthazar EJ, Megibow AJ, Hulnick DH (1985) Cytomegalovirus oesophagitis and gastritis in acquired immune deficiency syndrom. AJR 144: 1201–1204

    Google Scholar 

  18. Balthazar EJ, Megibow AJ, Fazzini E, Opulencia JF, Engel I (1985) Cytomegalovirus colitis: radiographic findings in 11 patients. Radiology 155: 585–589

    Google Scholar 

  19. Balthazar EJ, Megibow AJ, Hulnick D, Chok C, Beranbaum E (1987) Cytomegalovirus oesophagitis in AIDS: radiographic features in 16 patients. AJR 149: 919–925

    Google Scholar 

  20. Cho S, Tisnado J, Liu C, Beachley MC, Shaw C, Kipreos BE, Schneider V (1981) Bleeding cytomegalovirus ulcers of the colon: barium enema and angiography. AJR 136: 1213–1215

    Google Scholar 

  21. Frank D, Raicht RF (1984) Intestinal perforation with CMV in patients with acquired immune deficiency syndrome. Am J Gastroenterol 79: 201–205

    Google Scholar 

  22. Galloway PG (1984) Widespread cytomegalovirus infection involving the gastrointestinal tract, biliary tree, and gallbladder in an immuno-compromised patient. Gastroenterology 87: 1407

    Google Scholar 

  23. Gertler SL, Pressman J, Price P, Brozinsky S, Miyai K (1983) Gastrointestinal cytomegalovirus infection in a homosexual man with severe acquired immunodeficiency syndrome. Gastroenterology 85: 1403–1406

    Google Scholar 

  24. Knapp AB, Horst DA, Eliopoulos G, Gramm HF, Gaber LW, Falchuk KR, Falchuk ZM, Trey C (1983) Widespread cytomegalovirus gastroenterocolitis in a patient with acquired immune deficiency syndrome. Gastroenterology 85: 1399–1402

    Google Scholar 

  25. Spiegel JS, Schwabe AD (1980) Disseminated cytomegalovirus infection with gastrointestinal involvement: the role of altered immunity in the elderly. Am J Gastroenterol 73: 37–44

    Google Scholar 

  26. Ayulo M, Aisner SC, Margolis K, Moravec C (1980) Cytomegalovirus-associated gastritis in a compromised host. JAMA 243: 1364

    Google Scholar 

  27. Cooper HS, Raffensperger EC, Jonas L (1977) Cytomegalovirus inclusions in patients with ulcerative colitis and toxic dilatation requiring colonic resection. Gastroenterology 72: 1253–1256

    Google Scholar 

  28. Meiselman MS, Cello JP, Margareten W (1985) Cytomegalovirus colitis in acquired immune deficiency syndrome. Gastroenterology 88: 171–175

    Google Scholar 

  29. St Onge G, Bezahler GH (1982) Giant esophageal ulcer associated with cytomegalovirus. Gastroenterology 83: 127–130

    Google Scholar 

  30. Teixidor HS, Honig CL, Norsoph E, Alberts S, Mouradian JA, Whalen JP (1987) Cytomegalovirus infection of the alimentary canal: radiologic findings with pathologic correlation. Radiology 163: 317–325

    Google Scholar 

  31. Campbell DA, Piercey RA, Shnitka TK, Goldsand G, Devine RDO, Weinstein WM (1977) Cytomegalovirus-associated gastric ulcer. Gastroenterology 72: 533–535

    Google Scholar 

  32. Weinstein L, Edelstein SM, Madara JL, Falchuk KR, McManus BM, Trier JS (1981) Intestinal cryptosporidiosis complicated by disseminated cytomegalovirus infection, Gastroenterology 81: 584–91

    Google Scholar 

  33. Bartelsman JFWM, Tytgat GNJ (1990) Gastrointestinal and hepatobiliary complications in patients with HIV infection. In: Current Topics in Gastroenterology and Hepatology. Tytgat GNJ, van Blankenstein MJ (eds), Thieme Verlag, Stuttgart: 572–580

    Google Scholar 

  34. Foucar E, Mukai K, Foucan K (1981) Colon ulceration in lethal cytomegalovirus infection. Am J Clin Pathol 76: 788–801

    Google Scholar 

  35. Blumberg RS, Kelsy P, Perrone T (1984) Cytomegalovirus and cryptosporidia associated acalculous cholecystitis. Am J Med 76: 118–123

    Google Scholar 

  36. Kavin H, Jonas RB, Chowdhury L, Kabins S (1986) Acalculous cholecystitis and cytomegalovirus infeciton in acquired immune deficiency syndrome. Ann Intern Med 104: 53–54

    Google Scholar 

  37. Goodman MD, Poster DD (1973) Cytomegalovirus vasculitis with fatal colonic hemorrhage. Arch Pathol 96: 281–284

    Google Scholar 

  38. Pitchenik AE, Cole C, Russell BW, Fischl MA, Spira TJ, Snider DE (1984) Tuberculosis, atypical mycobacteriosis, and the acquired immunodeficiency syndrome among Haitian and non-Haitian patients in South Florida. Ann Intern Med 101: 641–645

    Google Scholar 

  39. Goodman P, Pinero SS, Rance RM, Mansell DWA, Uribe-Botero G (1989) Mycobacterial esophagitis in AIDS. Gastrointest Radiol 14: 103–105

    Google Scholar 

  40. Brody JM, Miller DK, Zeman RK, Klappenbach RS, Jaffe MH, Clark LR, Benjamin SB, Choyke PL (1986) Gastric tuberculosis: a manifestation of AIDS, Radiology 159: 347–348

    Google Scholar 

  41. Lee SH, Hall-Craggs MA, Lees WR (1987) Appendix mass in AIDS. Br J Radiol 60: 1030–1031

    Google Scholar 

  42. Thoeni RF, Margulis AR (1979) Gastrointestinal tuberculosis. Semin Roentgenol 14: 283–294

    Google Scholar 

  43. Nyberg DA, Federle MP, Jeffrey RB, Bottles K, Wofsy CB (1985) Abdominal CT findings in disseminated Mycobacterium Avium-Intracellulare. AJR 145: 297–299

    Google Scholar 

  44. Autran B, Gorin I, Leibowitch M (1983) Acquired immune deficiency syndrome in a Haitian woman with cardiac Kaposi sarcoma and Whipple's disease. Lancet I: 767–768

    Google Scholar 

  45. Roth R, Owen RL, Keven DF (1983) Acquired immune deficiency syndrome with Mycobacterium Avium-Intracellulare lesions resembling those of Whipple's disease. N Engl J Med 309: 1324–1335

    Google Scholar 

  46. Vincent ME, Robbins AR (suppl) (1985) Mycobacterium-Avium-Intracellulare complex enteritis: pseudo-Whipple's disease in acquired immune deficiency. AJR 144: 921–922

    Google Scholar 

  47. Berk RN, Wall SD, McCardle CB (1984) Cryptosporidiosis of the stomach and small intestine in patients with acquired immune deficiency syndrome. AJR 143: 549–554

    Google Scholar 

  48. Gross TL, Wheat J, Barlett M, O'Connor KW (1986) AIDS and multisystem involvement with cryptosporidium. Am J Gastroenterol 81: 456–458

    Google Scholar 

  49. Nime FA, Burek JD, Page D (1987) Acute enterocolitis in a human being infected with the protozoan Cryptosporidium. Gastroenterology 145: 297–299

    Google Scholar 

  50. Tzipori S, Smith M, Burch C (1983) Cryptosporidiosis in hospital patients with gastroenteritis. Am J Trop Med Hyg 32: 9341–4

    Google Scholar 

  51. Cooper DA, Wodak A, Marriot DJE (1984) Cryptosporidiosis in AIDS. Pathology 16: 455–457

    Google Scholar 

  52. Sider L, Mintzer RA, Mendelson EB (1982) Radiologic findings of infectious proctitis in gay men. AJR 139: 667–672

    Google Scholar 

  53. Kaposi M (1872) Idiopathisches multiples Pigmentsarkom der Haut. Arch Dermatol 4: 265–273

    Google Scholar 

  54. Federle MP, Nyberg DA, Hulnick DH, Jeffrey RB (1988) Malignant neoplasms: Kaposi's sarcoma, lymphoma and other diseases with similar radiographic features. In: Federle MP, Megibow A, Naidich DP (eds) Radiology of acquired immune deficiency syndrome. Raven press, New York, pp 107–129

    Google Scholar 

  55. Friedman-Klein AE, Laubenstein LJ, Rubinstein P (1982) Disseminated Kaposi's sarcoma in homosexual men. Ann Intern Med 96: 693–700

    Google Scholar 

  56. Hill CA, Harle TS, Manseel PWA (1983) The prodrome. Kaposi sarcoma and infection associated with acquired immune deficiency syndrome. Radiologic findings in 39 patients. Radiology 149: 393–399

    Google Scholar 

  57. Nyberg DA, Federle MP (1987) AIDS-related Kaposi sarcoma and lymphoma. Semin Roentgenol 22: 54–65

    Google Scholar 

  58. Niedt GW, Schinella RA (1985) Acquired immunodeficiency syndrome. Clinicopathologic study of 56 autopsies. Arch Pathol Lab Med 109: 727–734

    Google Scholar 

  59. Jaffe HW, Bregman DJ, Selik RM (1983) Acquired immune deficiency syndrome in the United States; the first one thousand cases. J Infect Dis 148: 339–345

    Google Scholar 

  60. Longo DL (1984) Kaposi's sarcoma and other neoplasms. Ann Intern Med 100: 92–106

    Google Scholar 

  61. Emery CD, Wall SD, Federle MP, Sooy CD (1986) Pharyngeal Kaposi sarcoma in patients with AIDS. AIR 147: 919–922

    Google Scholar 

  62. Lozada F, Silverman S, Conant M (1982) New outbreak of oral tumors, malignancies and infectious diseases strikes young male homosexuals. C. D. A. J. 10: 30–42

    Google Scholar 

  63. Lozada F, Silverman S, Migliorati CA (1983) Oral manifestations of tumor and opportunistic infections in the acquired immunodeficiency syndrome (AIDS): findings in 53 homosexual men with Kaposi's sarcoma. Oral Surg 56: 491–494

    Google Scholar 

  64. Reed WB, Kamath HM, Weiss L (1974) Kaposi's sarcoma with emphasis on the internal manifestations. Arch Dermatol 110: 115–118

    Google Scholar 

  65. Rose HS, Balthazar EJ, Megibow AJ, Horowitz L, Lautenstein LJ (1982) Alimentary tract involvement in Kaposi sarcoma. Radiographic and endoscopic findings in 24 homosexual men. AJR 139: 661–666

    Google Scholar 

  66. Weprin L, Zollinger R, Clausen KM (1982) Kaposi's sarcoma: endoscopic observations of gastric and colon involvement. J Clin Gastroenterol 4: 357–600

    Google Scholar 

  67. Urba WS, Longo DL (suppl) (1985) Clinical spectrum of human retroviral in diced diseases. Cancer Res 45: 4637s-4643s

  68. Landesman SH, Ginzburg HM, Weiss SH (1985) Special report; the AIDS epidemic. N Engl J Med 312: 521–524

    Google Scholar 

  69. Ioachim HL, Cooper MC, Hellman GC (1985) Lymphomas in men at high risk for acquired immune deficiency syndrome (AIDS). Cancer 56: 2831–2842

    Google Scholar 

  70. Nyberg DA, Jeffrey RB, Federle MP, Bottles K, Abrams DI (1986) AIDS-related lymphomas: evaluation by abdominal CT. Radiology 159: 59–63

    Google Scholar 

  71. Townsend RR, Laing FC, Jeffrey RB, Bottler K (1989) Abdominal lymphoma in AIDS: evaluation with US. Radiology 171: 719–724

    Google Scholar 

  72. Ziegler JL, Beckstead JA, Volberding PA, Abrams DI, Levine AM, Lukes RJ, Gill PS, Burkes RL, Meyer PR, Metroka CE, Mouradian J, Moore A, Riggs SA, Butler JJ, Cabanillas FC, Hersch E, Newell GR, Laubenstein LJ, Knowles D, Odajnyk C, Raphael B, Koriner B, Urmacher C, Clarkson BD (1984) Non-Hodgkin's lymphoma in 90 homosexual men: relation to generalized lymphadenopathy and the acquired immunodeficiency syndrome. N Engl J Med 311: 565–570

    Google Scholar 

  73. Reeders JWAJ, Megibow AJ, Antonides HR (1991) Gastrointestinal Radiology of AIDS. In: Diagnostic Imaging of AIDS (Ed: Reeders JWAJ), G. Thieme Verlag, Stuttgart (in press): 1–144

    Google Scholar 

  74. Megibow AJ, Balthazar EJ, Bosniak MA, Naidich DP (1983) Computed tomography of gastrointestinal lymphoma, AJR 141: 541–548

    Google Scholar 

  75. Megibow AJ (1986) Gastrointestinal lymphoma: the role of CT in diagnosis and management. Semin Ultrasound CT MR 7: 43–57

    Google Scholar 

  76. Frager DH, Wolfe EL, Competiello LS, Frager JD, Klein RS, Beneventano TC (1988) Squamous cell carcinoma of the esophagus in patients with AIDS. Gastrointest Radiol 13: 358–360

    Google Scholar 

  77. Albin J, Lewis E, Eftekhari F, Shirkhoda A (1987) Computed tomography of rectal and perirectal diseases in AIDS patients. Gastrointest Radiol 12: 67–71

    Google Scholar 

  78. Amodio JB, Abramson S, Berdon WE, Levy J (1987) Pediatric AIDS. Semin Roentgeno l22: 66–76

    Google Scholar 

  79. Abiri MM, Kirpekar M, Abiris S (1985) The role of ultrasonography in the detection of extrapulmonary tuberculosis in patients with AIDS. J Ultrasound Med 4: 471–473

    Google Scholar 

  80. Buck BE, Scott G, Dapena M (1983) Kaposi sarcoma in 2 infants with AIDS, J Pediatr 103: 911–913

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of GI Radiology, Gastroenterology, Academic Medical Center (AMC), Amsterdam, The Netherlands

    J. W. A. J. Reeders, J. F. W. M. Bartelsman, H. R. Antonides & G. N. J. Tytgat

  2. Department of Radiology, Ziekenhuis Zonnegloren, Soest, The Netherlands

    J. W. A. J. Reeders, J. F. W. M. Bartelsman, H. R. Antonides & G. N. J. Tytgat

Authors
  1. J. W. A. J. Reeders
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. F. W. M. Bartelsman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. R. Antonides
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. N. J. Tytgat
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reeders, J.W.A.J., Bartelsman, J.F.W.M., Antonides, H.R. et al. The spectrum of gastrointestinal radiology in AIDS. Eur. Radiol. 1, 33–45 (1991). https://doi.org/10.1007/BF00540101

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00540101

Key words

Search

Navigation