AUTOPSY FINDINGS IN PATIENTS WITH AIDS

Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.

AUTOPSY FINDINGS IN PATIENTS WITH AIDS

Kaposi's Sarcoma: A Text and Atlas. Gottlieb GJ, Ackerman AB, eds. Philadelphia, Lea and Febiger, p. 271-87, 1988.. Unique Identifier : AIDSLINE ICDB/88647207
Niedt GW; Schinella RA; Dept. of Pathology, New York Univ. Sch. of Medicine, New York, NY

Abstract: Findings in 56 patients (pts) with acquired immune deficiency syndrome (AIDS) who were autopsied by the authors and in published autopsy reports are reviewed. At autopsy, pts with AIDS usually are young men about 40 yr old. Most are homosexuals, but some are iv drug abusers or Haitians, and a few belong to two or more risk groups. Some have long histories of infectious diseases, notably syphilis, hepatitis (all types), gonorrhea and, to a lesser extent, amebiasis and giardiasis. AIDS pts also suffer from neoplasms, of which Kaposi's sarcoma (KS) is the most common, but they also are subject to a variety of malignant lymphomas. The most common infections found at autopsy in 127 cases were as follows: cytomegalovirus (78%), Candida (thrush, 47%), Pneumocystis (34%), nonmycobacterial bacteria (26%), Mycobacterium avium-intracellulare (20%), Candida (disseminated, 17%), herpes simplex or zoster (12%), Cryptococcus (11%), mycobacteria (uncultured, 6.3%), Toxoplasma (5.5%), and Aspergillus (5.5%). Various other infections occurred at rates of less than 5%. KS develops in about 50% of cases of AIDS (29/56 pts in the authors' own series). The most striking difference between KS seen in pts with AIDS and that seen in pts who do not have AIDS is its highly aggressive nature in those with AIDS. In the authors' series, over 95% of cases had visceral involvement. In a series of 62 autopsies, the following sites of involvement of KS were reported: skin (94%), gastrointestinal tract (57%), lung (52%), lymph nodes (50%), liver (23%), spleen (13%), pharynx/larynx (11%), adrenals (8%), and pericardium (6%). Among the other findings at autopsy of AIDS pts are severe emaciation, evidence of pulmonary disease in the lungs, deposition of hemosiderin in the liver, extensive brain necrosis when fungus or Toxoplasma is present, and maturation arrest in the testes. The most profound changes are seen the lymphoid organs. The thymus is depleted of lymphoid elements, and lymphoid neoplasms are often found in AIDS pts. (48 Refs)

Keywords: Acquired Immunodeficiency Syndrome/*PATHOLOGY Autopsy Human Neoplasms, Multiple Primary/PATHOLOGY Opportunistic Infections/PATHOLOGY Sarcoma, Kaposi's/*PATHOLOGY Skin/PATHOLOGY Skin Neoplasms/*PATHOLOGY MONOGRAPH REVIEW, TUTORIAL REVIEW

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M88B0594

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