Neuropathology of the acquired immune deficiency syndrome (AIDS): report of 39 autopsies from Vancouver, British Columbia.
Neuropathological findings from 39 acquired immune deficiency syndrome (AIDS) autopsies of primarily neurologically symptomatic patients and 7 brain biopsies from AIDS patients performed at St. Paul's Hospital, Vancouver, British Columbia are reported. Autopsy findings included human immunodeficiency virus-1 (HIV)-type multinucleated giant cell (MNGC)-associated encephalitis seen in 17 patients, toxoplasmosis in 7 patients, and cytomegalovirus encephalitis and/or microglial nodule-associated nuclear inclusions in brain parenchyma in 9 patients. Central nervous system lymphoma was identified in 11 autopsy patients and in 4 of 7 brain biopsies. Infectious processes including HIV encephalitis were seen in 10 of 11 autopsied patients with lymphoproliferative lesions in the brain parenchyma, while 40% of patients without lymphoma had HIV-type MNGC or opportunistic infections. CNS lymphoma was not significantly increased in incidence in patients with a clinical history of zidovudine treatment, but increased duration of survival after the diagnosis of AIDS was associated with increased incidence of lymphoma in both untreated and zidovudine-treated patients. Patients displaying HIV MNGC within microglial nodules had a shorter mean duration of survival after diagnosis of AIDS than those patients with HIV encephalitis with dispersed MNGC, white matter vacuolation, and gliosis.
Cornford
M E
ME
Department of Pathology, UCLA Center for Health Sciences 90024-1732.
Holden
J K
JK
Boyd
M C
MC
Berry
K
K
Vinters
H V
HV
D015526:AIDS Dementia Complex / Q000473:pathology*; D017088:AIDS-Related Opportunistic Infections / Q000473:pathology*; D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology*; D000328:Adult; D000368:Aged; D001344:Autopsy; D001706:Biopsy; D001921:Brain / Q000473:pathology*; D001955:British Columbia; D016543:Central Nervous System Neoplasms / Q000382:microbiology / Q000473:pathology; D003586:Cytomegalovirus Infections / Q000473:pathology; D004660:Encephalitis / Q000382:microbiology / Q000473:pathology; D005260:Female; D015497:HIV-1; D006801:Humans; D008223:Lymphoma / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016781:Toxoplasmosis, Cerebral / Q000473:pathology