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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
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Abstract:

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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

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