Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
NEUROPATHOLOGY OF AIDS
AIDS, Acquired Immune Deficiency Syndrome, and other Manifestations of HIV Infection. Wormser GP et al, eds. Park Ridge, NJ, Noyes Publications, p. 935-47, 1987.. Unique Identifier : AIDSLINE ICDB/88647015 Valsamis MP; Bird S. Coler Hosp., New York Medical Coll., New York, NY
Abstract:
A striking feature of the brain involvement in acquired immunodeficiency syndrome (AIDS) is the multiplicity and variety of infections encountered. The lesions encountered in the nervous system of patients with AIDS are described, including the general concerns of the neuropathologist, bacterial infections, fungal infections, protozoa, viral infections, human immunodeficiency virus (HIV) infection of the nervous system, and AIDS-associated neoplasms. Examination of several cases in which HIV has been demonstrated in the nervous system revealed the following characteristics: (1) multinucleated cells in which the nuclei have a peripheral distribution (Langhan's type) and multinucleated cells in which the nuclei are centrally aggregated (Warthin-Finkeldey type); (2) microglial nodules in the gray matter; and (3) elongated activated microglial cells ('rod cells') scattered throughout the gray matter and less frequently the white matter. In a routine examination of the brain, the diagnosis of presumptive HIV infection could be based on the following: (1) a progressive dementia in a patient with AIDS; (2) the presence of rod cells in significant numbers scattered throughout the cortex and white matter, along with glial nodules in cortex and white matter; and (3) the presence of Warthin-Finkeldey cells, both in areas of necrosis and within normal tissue. In AIDS, Kaposi's sarcoma (KS) and primary intracranial lymphomas have been most prominent. However, no case of KS primary to the CNS has been reported. CNS lymphomas frequently cause the presenting symptoms of AIDS. These lesions have been of the non-Hodgkin's type and are unusual in that they are frequently primary within the CNS, whereas spontaneous non-Hodgkin's lymphomas rarely are encountered in this location. The lymphomas encountered in AIDS are usually nondifferentiated lymphomas of the relatively rare Burkitt's-like type. The multiplicity of organisms and coexistence of multiple pathologic processes within individual lesions make a thorough, all-inclusive examination necessary for diagnostic completeness. (35 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*PATHOLOGY Brain/*PATHOLOGY Brain Neoplasms/PATHOLOGY Human Lymphoma/PATHOLOGY Opportunistic Infections/PATHOLOGY Sarcoma, Kaposi's/PATHOLOGY MONOGRAPH REVIEW, TUTORIAL REVIEW
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Important note: Information in this article was accurate in 1988. The state of the art may have changed since the publication date.
