Spindle cell reaction to nontuberculous mycobacteriosis in AIDS mimicking a spindle cell neoplasm. Evidence for dual histiocytic and fibroblast-like characteristics of spindle cells.
We report 5 patients with AIDS who had an unusual spindle cell proliferation in the lymph nodes and skin caused by nontuberculous mycobacteriosis. The spindle cell proliferation in these tissues may mimic a spindle cell neoplasm and pose a diagnostic problem if an infectious aetiology is not suspected. The fibroblast-like spindle cells contained numerous acid fast bacilli. They were strongly positive for antibody markers of monocyte/macrophage and leukocyte derivation: Leu M3, Mo-9, T-200, and HLA-DR, and variably positive for alpha-1 anti-chymotrypsin and lysozyme. Ultrastructurally these spindle cells were predominantly fibroblast-like with poorly developed features of macrophages. These results reveal the dual macrophage and fibroblastic character of the spindle cells and probably imply a functional differentiation rather than a histogenetic one.
Brandwein
M
M
Department of Pathology, Mount Sinai School of Medicine, New York, NY.
Choi
H S
HS
Strauchen
J
J
Stoler
M
M
Jagirdar
J
J
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D002277:Carcinoma / Q000473:pathology*; D002455:Cell Division; D005347:Fibroblasts / Q000382:microbiology / Q000473:pathology; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008854:Microscopy, Electron; D009161:Mycobacterium / Q000302:isolation & purification; D009164:Mycobacterium Infections / Q000150:complications* / Q000276:immunology / Q000473:pathology; D012867:Skin / Q000473:pathology