Histopathology of the central nervous system in the acquired immunodeficiency syndrome.

Important note: Information in this article was accurate in 1987. The state of the art may have changed since the publication date.

Histopathology of the central nervous system in the acquired immunodeficiency syndrome.

Hum Pathol. 1987 Jun;18(6):636-43. Unique Identifier : AIDSLINE MED/87248713
Rhodes RH

Abstract: Histopathologic findings in the central nervous system in 100 autopsy cases of the acquired immunodeficiency syndrome (AIDS) gave evidence of a variety of opportunistic infections and probably of infection by human immunodeficiency virus (HIV). Gliomesenchymal cell nodules (47 per cent of cases) and spongiform alterations with demyelination were common. Vasculitides (8 per cent) and lesions such as acute hemorrhagic leukoencephalitis may be attributable partly to hypersensitivity reactions. Multinucleated cells, including giant cells that could be a hallmark of HIV encephalitis, were common in normal neuropil, in gliomesenchymal cell nodules, near blood vessels, and in cavitating lesions. Degeneration in long tracts (13 per cent) included posterior column demyelination and spongiform change with or without corticospinal tract degeneration. Some long tract degeneration appeared to originate from bilateral degeneration of the internal capsule, and this may be part of the origin of subacute combined degeneration-like changes in AIDS vacuolar myelopathy. Prominent brainstem inflammatory infiltration suggests that the brainstem is a relatively prominent site of infection or immunopathologic activity. Early ependymal lesions in infants and frequent healed ependymal lesions in adults (16 per cent) could be related to the origin and pathogenesis of HIV lesions in the brain. Some characteristic lesions in AIDS encephalitis may result from immune-mediated responses to HIV antigens on neural cell receptors or from cross-reactivity occurring against epitopes common to neural constituents and to hematopoietic cells, with the latter being under direct antiviral attack.

Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*PATHOLOGY Adult Anoxia/COMPLICATIONS/PATHOLOGY Blood Vessels/PATHOLOGY Central Nervous System/*PATHOLOGY Central Nervous System Diseases/COMPLICATIONS/PATHOLOGY Child Child, Preschool Demyelinating Diseases/COMPLICATIONS/PATHOLOGY Female Human Infant Infection/COMPLICATIONS/PATHOLOGY Inflammation/COMPLICATIONS/PATHOLOGY Lymphoma/COMPLICATIONS/PATHOLOGY Male Middle Age Nerve Degeneration JOURNAL ARTICLE

871030
M87A0373

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