Progressive lymph node histology and its prognostic value in patients with acquired immunodeficiency syndrome and AIDS-related complex.
Seventy-four sequential lymph node biopsies from 30 acquired immunodeficiency syndrome (AIDS)/AIDS-related complex (ARC) patients showed temporal histologic progression from explosive follicular hyperplasia (EFH) to mixed follicular hyperplasia/involution (mixed) to follicular involution (FI) to lymphocyte depletion (LD). This histologic progression correlated with symptoms, development of opportunistic infections (OI), and mortality. At initial biopsy, only 50% of the AIDS/ARC patients with EFH/mixed compared to 100% with FI/LD were symptomatic with weight loss, night sweats, diarrhea, fever, or fatigue. 31% of ARC patients with EFH and 63% with FI developed an OI in a median of 69 months and 5 months, respectively; 86% with LD had a concurrent or previous OI. Ninety percent of ARC patients progressing to FI/LD died; 85% of those persisting with EFH/mixed remained alive 18 to 50 months after initial biopsy. AIDS patients with EFH lived twice as long as those with FI/LD. Progressive histology did not correlate with lymphoma. The number of ARC patients developing Kaposi's sarcoma was too small to draw definitive conclusions.
Chadburn
A
A
Department of Pathology, New York Hospital-Cornell Medical Center, NY 10021.
Metroka
C
C
Mouradian
J
J
D000386:AIDS-Related Complex / Q000150:complications / Q000473:pathology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000473:pathology*; D001706:Biopsy; D006801:Humans; D006965:Hyperplasia / Q000209:etiology / Q000473:pathology; D008198:Lymph Nodes / Q000473:pathology*; D008214:Lymphocytes / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000209:etiology; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology; D011379:Prognosis; D012514:Sarcoma, Kaposi / Q000209:etiology