PULMONARY PATHOLOGY OF ACQUIRED IMMUNE DEFICIENCY SYNDROME IN CHILDREN NLM AIDSLINE Important note: Information in this article was accurate in 1990. The state of the art may have changed since the publication date.

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PULMONARY PATHOLOGY OF ACQUIRED IMMUNE DEFICIENCY SYNDROME IN CHILDREN

Aspen Semin Pediatr Dis; 2:187-206 1989. Unique Identifier : AIDSLINE ICDB/90658250
Joshi VV; Morrison S; Connor EM; Marquis J; Oleske JM; Dept. of Pathology, Children's Hosp. of New Jersey, United; Hospitals Medical Center, Newark, NJ

Abstract: Since the recognition of pediatric AIDS, pulmonary lesions have been of special clinical significance because of their role in the diagnosis and management of the syndrome. Data are reported for a total of 33 children (20 boys, 13 girls; 5 mo to 7 yr old; many with two lesions); lung biopsies were done in 21 patients (pts), autopsies only in 2 pts, and biopsies and autopsies in 10 pts. The following pulmonary lesions were observed: pulmonary lymphoid hyperplasia/lymphoid interstitial pneumonitis (PLH/LIP) complex (19 lesions), polyclonal polymorphic B-cell lymphoproliferative disorder (PBLD; 2), desquamative interstitial pneumonitis (DIP; 3), bacterial pneumonia (2), opportunistic infections (14), diffuse alveolar damage (6), chronic passive congestion and/or edema (2), and nonspecific minimal abnormalities (1). Follicular hyperplasia of lymph nodes was commonly seen in children with PLH/LIP complex. Although there were rare exceptions, thymitis characterized by medullary lymphoid follicles or multinucleated giant cells was seen in children with PLH/LIP complex, whereas precocious involution, dysinvolution, or thymitis characterized by diffuse lymphoplasmacytic infiltrate was present in children with opportunistic infection or DIP. The PLH/LIP complex responded to steroid therapy, but in all cases there was some degree of persistence of disease. Pulmonary fibrosis was not seen in any of the pts. The long survival of pts with PLH/LIP complex compared to those with opportunistic infection suggests that PLH/LIP is associated with a better prognosis. However, the possibility of its progression to PBLD, as observed in 2 of the pts, or to full-fledged monoclonal lymphoma as reported in the literature, may result in a fatal outcome in children with PLH/LIP. Prognosis in these children is therefore guarded, and they should be observed regularly to detect such a progression. (35 Refs)
Keywords: Acquired Immunodeficiency Syndrome/*PATHOLOGY Biopsy Child Child, Preschool Human Hyperplasia Infant Lung/PATHOLOGY Lung Diseases/*PATHOLOGY Lymph Nodes/PATHOLOGY Lymphoproliferative Disorders/PATHOLOGY Opportunistic Infections/*PATHOLOGY Pneumonia, Pneumocystis carinii/PATHOLOGY Pulmonary Alveoli/PATHOLOGY Pulmonary Fibrosis/PATHOLOGY Thymus Gland/PATHOLOGY JOURNAL ARTICLEKWDacquiredimmunodeficiencysyndrome/KWDpathologybiopsychildchild,preschoolhumanhyperplasiainfantlung/pathologylungdiseases/KWDpathologylymphnodes/pathologylymphoproliferativedisorders/pathologyopportunisticinfections/KWDpathologypneumonia,pneumocystiscarinii/pathologypulmonaryalveoli/pathologypulmonaryfibrosis/pathologythymusgland/pathologyjournalarticle
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Copyright © 1990 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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