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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
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
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Abstract:

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.

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Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1992

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