Hostname: page-component-745bb68f8f-b6zl4 Total loading time: 0 Render date: 2025-01-24T01:46:52.836Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropathology of the Acquired Immune Deficiency Syndrome (AIDS): Report of 39 Autopsies from Vancouver, British Columbia

Published online by Cambridge University Press:  18 September 2015

Marcia E. Cornford ,
Janet K. Holden ,
Michael C. Boyd ,
Kenneth Berry  and
Harry V. Vinters
Marcia E. Cornford*
Affiliation:
Department of Pathology, Vancouver General Hospital, Vancouver
Janet K. Holden
Affiliation:
UCLA Center for Health Sciences, Los Angeles; Departments of Pathology, Vancouver General Hospital, Vancouver
Michael C. Boyd
Affiliation:
Surgery, St. Paul’s Hospital, Vancouver
Kenneth Berry
Affiliation:
Department of Pathology, Vancouver General Hospital, Vancouver
Harry V. Vinters
Affiliation:
Brain Research Institute, Vancouver General Hospital, Vancouver
*
Department of Pathology, UCLA Center for Health Sciences, 10833 Le Conte Ave., Los Angeles, CA 90024-1732
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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 (HlV)-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.

Type
Articles
Information
Canadian Journal of Neurological Sciences , Volume 19 , Issue 4 , November 1992 , pp. 442 - 452
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

References

REFERENCES

1.Anders, KH, Guerra, WF, Tomiyasu, U, et al. The neuropathology of AIDS: UCLA experience and review. Am J Pathol 1986; 124: 537–558.Google ScholarPubMed
2.Rhodes, RH.Histopathology of the central nervous system in the acquired immunodeficiency syndrome. Hum Pathol 1987; 18: 636–643.CrossRefGoogle ScholarPubMed
3.Levy, RM, Janssen, RS, Bush, TJ, et al. Neuroepidemiology of acquired immunodeficiency syndrome. J Acquir Immune Defic Syndr 1988; 1: 31–40.Google ScholarPubMed
4.Kure, K, Llena, JF, Lyman, WD, el al. Human immunodeficiency virus-1 infection of the nervous system. An autopsy study of 268 adult, pediatric and fetal brains. Hum Pathol 1991; 22: 700–710.CrossRefGoogle ScholarPubMed
5.Petito, CK, Cho E-S, Lemann, W, et al. Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy review. J Neuropathol Exp Neurol 1986; 45: 635–646.CrossRefGoogle ScholarPubMed
6.de la Monte, SM, Ho, DD, Schooley, RT, et al. Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection. Neurology 1987; 37: 562–569.CrossRefGoogle ScholarPubMed
7.de Girolami, U, Smith, TW, Hènin, D, et al. Neuropathology of the acquired immunodeficiency syndrome. Arch Pathol Lab Med 1990; 114: 643–655.Google ScholarPubMed
8.Moskowitz, LB, Hensley, GT, Chan, JC, et al. Neuropathology of acquired immune deficiency syndrome. Arch Pathol Lab Med 1984; 108: 867–872.Google ScholarPubMed
9.Lantos, PL, McLaughlin, JE, Scholtz, CL, et al. Neuropathology of the brain in HIV infection. Lancet 1989; 1: 309–311.CrossRefGoogle ScholarPubMed
10.Esiri, MM, Scaravilli, F.Millard, PR, et al. Neuropathology of HIV infection in haemophiliacs: comparative necropsy study. Br Med J 1989; 299: 1312–1315.CrossRefGoogle ScholarPubMed
11.Hènin, D, Duyckaerts, C.Chaunu, MP, et al. Etude neuropathologique de 31 cas de syndrome d’immuno-dèpression acquise. Rev Neurol (Paris) 1987; 143: 631–642.Google Scholar
12.Gray, F, Gherardi, R.Keohane, C, et al. Pathology of the central nervous system in 40 cases of acquired immune deficiency syndrome (AIDS). Neuropathol Appi Neurobiol 1988; 14: 365–380.CrossRefGoogle ScholarPubMed
13.Lang, W, Miklossy, J.Deruaz, JP.et al. Neuropathology of the acquired immune deficiency syndrome (AIDS): a report of 135 consecutive autopsy cases from Switzerland. Acta Neuropathol 1989; 77: 379–390.CrossRefGoogle ScholarPubMed
14.Kleihues, P, Leib, SL, Strittmatter, C.et al. HIV encephalopathy: incidence, definition, and pathogenesis. Acta Pathol Jpn 1991; 41: 197–205.Google ScholarPubMed
15.Giampalmo, A, Pesce, C, Ardoino, S, et al. Neuropathological findings in an autopsy series of Italian subjects with AIDS. Clin Neuropathol 1989; 8: 120–125.Google Scholar
16.Budka, H, Costanzi, G, Cristina, S, et al. Brain pathology induced by infection with the human immunodeficiency virus (HIV). Acta Neuropathol (Berlin) 1987; 75: 185–198.CrossRefGoogle ScholarPubMed
17.Stavrou, D, Mehraein, P.Mellen, W.et al. Evaluation of intracerebral lesions in patients with acquired immunodeficiency syndrome. Neuropathological findings and experimental data. Neuropathol Appl Neurobiol 1989; 15: 207–222.CrossRefGoogle ScholarPubMed
18.Rosemberg, S, Lopes, MBS, Tsanaclis, AM.Neuropathology of acquired immunodeficiency syndrome (AIDS). Analysis of 22 Brazilian cases. J Neurol Sci 1986; 76: 187–198.Google ScholarPubMed
19.Funata, N, Maeda, Y.Koike, M, et al. Neuropathology of the central nervous system in acquired immune deficiency syndrome (AIDS) in Japan. Acta Pathol Jpn 1991; 41: 206–211.Google ScholarPubMed
20.Dickson, DW, Belman, AL, Park, YD.et al. Central nervous system pathology in pediatric AIDS: an autopsy study. APMIS 1989; (Suppl 8): 40–57.Google ScholarPubMed
21.Koppel, BS, Wormser, GP, Tuchman, AJ. el al. Ceniral nervous system involvement in patients with acquired immune deficiency syndrome (AIDS). Acta Neurologica Scand 1985; 71: 337–353.Google ScholarPubMed
22.Budka, H.The definition of HIV-specific neuropathology. Acta Pathol Jpn 1991; 41: 182–191.Google ScholarPubMed
23.Budka, H.Neuropathology of human immunodeficiency virus infection. Brain Pathol 1991; 1: 163–175.CrossRefGoogle ScholarPubMed
24.Centers for Disease Control. Revision of the CDC surveillance case definition for acquired immunodeficiency syndrome. MMWR 1987; 36 (Suppl 1S): 1S–9S.Google Scholar
25.Anders, KH, Latta, H, Chang, BS, et al. Lymphomatoid granulomatosis and malignant lymphoma of the central nervous system in the acquired immunodeficiency syndrome. Hum Pathol 1989; 20: 326–334.CrossRefGoogle ScholarPubMed
26.Vinters, HV, Anders, KH, Barach, P.Focal pontine leukoencephalopathy in immunosuppressed patients. Arch Pathol Lab Med 1987; 111: 192–196.Google ScholarPubMed
27.Wiley, CA, Nelson, JA.Role of human immunodeficiency virus and cytomegalovirus in AIDS encephalitis. Am J Pathol 1988; 133: 73–81.Google ScholarPubMed
28.Schmidbauer, M, Budka, H, Okeda, R, et al. Multifocal vacuolar leucoencephalopathy: a distinct HIV-associated lesion of the brain. Neuropathol Appl Neurobiol 1990; 16: 437–443.CrossRefGoogle ScholarPubMed
29.Pluda, JM, Yarchoan, R, Jaffe, ES, et al. Development of non-Hodgkin lymphoma in a cohort of patients with severe human immunodeficiency virus (HIV) infection on long-term antiretro-viral therapy. Ann Intern Med 1990; 113: 276–282.CrossRefGoogle Scholar
30.Cornford, ME.Said, JW, Vinters, HV.Immunohistochemical localization of human immunodeficiency virus (HIV) in central nervous system lymphoproliferative lesions of patients with AIDS. Mod Pathol 1991; 4: 232–238.Google ScholarPubMed
31.Vinters, HV, Kwok, MK, Ho, HW, et al. Cytomegalovirus in the nervous system of patients with the acquired immune deficiency syndrome. Brain 1989; 112: 245–268.CrossRefGoogle ScholarPubMed
32.Vinters, HV, Anders, KH.Opportunistic infections: Cytomegalovirus. In Neumpathologx of AIDS. Boca Raton: CRC Press, 1990; 29–45.Google Scholar
33.Morgello, S, Petito, CK, Mouradian, JA.Central nervous system lymphoma in the acquired immunodeficiency syndrome. Clin Neuropathol 1990; 9: 205–215.Google ScholarPubMed