Pathology of Mycobacterium aviumintracellulare infection in acquired immunodeficiency syndrome

The AIDS Autopsy Spleen: A Comparison of the Pre-Anti-Retroviral and Highly Active Anti-Retroviral Therapy Eras

“…Furthermore, we confirmed more curious findings in the literature, such as perivascular hyaline fibrosis (possibly an exaggeration of normal splenic histology, Fig. 9), splenic "para-amyloid" material, and spindle cell prolifer- ations (2,5,10,12,15). Inflammatory infiltrates, also previously described, were observed with some frequency in both patient groups in this study, including granulomas, plasma cells, extramedullary hematopoiesis, and neutrophilic microabscesses.…”

“…On the basis of histologic descriptions in the literature (2,14) and of our experience with surgical and non-AIDS autopsy spleens used as controls, a semiquantitative grading system measured the amount of white-pulp depletion. The grading was performed by examining a single entire histologic section at low power (4ϫ objective) and calculating the total estimated area of white pulp over the total estimated area of red pulp.…”

“…Pathologic findings in the spleens of acquired immune deficiency syndrome (AIDS) patients have been characterized in a small number of studies and case reports that were performed before the widespread use of highly active anti-retroviral therapy (HAART; [1][2][3][4][5][6]. HAART regimens consist of various combinations of nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors.…”

“…Specific histologic findings attributed to HIV in the spleen include amyloid-like protein deposition, perivascular hyalinization, infarcts, necrosis, hemosiderin pigment deposits, plasma cell infiltrates, neutrophilic microabscesses, spindle cell infiltrates, extramedullary hematopoiesis, and granulomatous reaction (2, 6, 10 -13). Some of these changes have been shown to be associated with specific infections (2). Our aim in this study was to compare AIDS splenic pathology in a more recent group of patients with splenic pathology in AIDS before the use of multiagent therapy (i.e., the pre-HAART era, 1982-1994).…”

Pathology of HIV/AIDS: Lessons from Autopsy Series

“…Cytoplasm of these cells is p a c k e d w i t h h u g e n u m b e r o f a c i d -f a s t b a c illi. Well-formed granulomas with fibrosis, necrosis, and epithelioid histiocytes are present in less than one third of cases (Klatt et al, 1987).…”