GENERAL PATHOLOGY OF AIDS

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

GENERAL PATHOLOGY OF AIDS

AIDS, Acquired Immune Deficiency Syndrome, and other Manifestations of HIV Infection. Wormser GP et al, eds. Park Ridge, NJ, Noyes Publications, p. 838-66, 1987.. Unique Identifier : AIDSLINE ICDB/88647012
Stahl RE; Dept. of Pathology, New York Medical Coll., Valhalla, NY

Abstract: The acquired immunodeficiency syndrome (AIDS) is associated with a variety of morphologic lesions which are neither specific nor diagnostic of AIDS or human immunodeficiency virus (HIV) infection, but which are characteristic of the disease. The pathologic features include lymphadenopathy and thymic abnormalities, manifestations of infection by HIV or opportunistic pathogens, and neoplasms. The general pathology of AIDS is discussed based on experience with 27 consecutive autopsies performed on prisoners with AIDS at Westchester County (New York) Medical Center and published autopsy studies of other populations of adult patients (pts) with AIDS. Most (96%) of the prisoners were iv drug abusers and all but two were heterosexual. The specific pathologic findings discussed include Pneumocystis carinii pneumonia, bronchopneumonia, cytomegalovirus infection, toxoplasmosis, candidiasis, cryptococcosis, histoplasmosis, aspergillosis, mycobacteriosis, Kaposi's sarcoma (KS), and lymphomas. Compared to autopsy results of pts who were predominantly male homosexuals, prisoner-iv drug abusers with AIDS have a much lower incidence of KS, a lower incidence of cytomegalovirus infections, and a higher incidence of lymphomas and cirrhosis. AIDS pts can have a multitude of severe life-threatening diseases simultaneously, with unusual clinical and histopathologic manifestations. Biopsy and culture of even the most subtle lesions in these pts is extremely important. Performing routine acid-fast and methenamine silver stains in addition to hematoxylin-eosin stains on all histologic material from an AIDS pt is mandatory, no matter what the histology of the lesion. The pathologist should be alert to the possibility of finding several different pathologic conditions in a single specimen. (29 Refs)

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

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