title: Histopathologic spectrum of AIDS-associated lesions in Maharaj Nakorn Chiang Mai Hospital.
abstract: The histopathological alterations in various organs and the presence of AIDS-associated lesions were studied in 86 biopsy and 29 necropsy specimens of AIDS patients. The most common cancer seen in this study were malignant lymphomas (4% of cases) with development of extensive extranodal lymphomatous involvement from the outset. Although a preponderance of high grade B-cell pathologic subtypes is found in AIDS-associated lymphoma, we also report the first case of T-lymphoblastic lymphoma with a picture of acute lymphoblastic leukemia (T-ALL). Tuberculosis (34% of cases) was the most common opportunistic infection presented in tissue sections, and the majority of tissue biopsies revealed poorly organized granulomas and extensive necrosis with numerous bacilli. Penicilliosis (20% of cases) appeared to be the most common cutaneous lesion with multiple organ involvement. The involved organs showed a partially anergic tissue reaction characterized by poorly formed granulomas with diffuse infiltrate of fungi-laden macrophages and lymphoid cell depletion. This organism has to be distinguished from Histoplasma capsulatum and other yeast-form fungi. Co-existing cytomegalovirus and P. carinii infections were the predominant findings in lung necropsy specimens from pediatric patients who died from AIDS. A major pathologic feature in this group was diffuse alveolar damage stage II to III with heavy loads of organism and extensive lymphoplasmacytic infiltration.
authors.affiliation: Department of Pathology, Faculty of Medicine, Chiang Mai University, Thailand.
authors.forename: L
authors.initials: L
authors.lastname: Bhoopat
authors.forename: K
authors.initials: K
authors.lastname: Thamprasert
authors.forename: B
authors.initials: B
authors.lastname: Chaiwun
authors.forename: C
authors.initials: C
authors.lastname: Attasiri
authors.forename: P
authors.initials: P
authors.lastname: Vithayasai
authors.forename: B
authors.initials: B
authors.lastname: Chaimongkol
authors.forename: T
authors.initials: T
authors.lastname: Limpichankit
authors.forename: V
authors.initials: V
authors.lastname: Sirisanthana
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology; D000328:Adult; D003586:Cytomegalovirus Infections / Q000209:etiology / Q000276:immunology / Q000473:pathology; D006761:Hospitals; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D008168:Lung / Q000276:immunology / Q000473:pathology; D008172:Lung Diseases, Fungal / Q000209:etiology / Q000276:immunology / Q000473:pathology; D008198:Lymph Nodes / Q000276:immunology / Q000473:pathology; D016131:Lymphocyte Subsets / Q000276:immunology; D016483:Lymphoma, AIDS-Related / Q000209:etiology / Q000276:immunology / Q000473:pathology*; D010407:Penicillium; D016720:Pneumocystis Infections / Q000209:etiology / Q000276:immunology / Q000473:pathology; D013785:Thailand / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000209:etiology / Q000276:immunology / Q000473:pathology