Systemic lymphadenopathy (LAS) in intravenous drug abusers. Histology, immunohistochemistry and electron microscopy: pathogenic correlations

Abstract

In the present study we have evaluated the histological, immunohistochemical, ultrastructural and cell surface phenotypic features of lymph nodes from 19 intravenous drug abusers and two homosexual men with persistent lymphadenopathy syndrome and from six control patients. Our investigation has demonstrated that the lymphadenopathy of drug abusers is characterized by: (a) specific histological features with evidence of evolution from an initial hyperplastic-reactive to a late regressive-destructive stage; (b) T-cell surface phenotype distribution similar to that in the peripheral blood of homosexuals; (c) peculiar infiltration of the germinal centres by T8+ cells and by S-100+, T6+ interdigitating reticulum-like cells; (d) electron microscopic features indicating the presence of virus bodies in lymph node cells and in the intercellular spaces. These data suggest that the lymphadenopathy of drug abusers and homosexuals are similar pathological conditions with characteristic features which allow histological differentiation of this entity from those found in other viral infections.

The value of lymph node biopsy in patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS‐related complex (ARC): a morphological and immunohistochemical study of 90 cases

“…Furthermore, notable activation of the T-cell system, as shown by the monoclonals ACT-1 and Ki-1, could be appreciated in three HTLV-III+ subjects who underwent lymph node biopsy because of recent lymph node swelling, but who did not fulfil the criteria of the CDC for an ARC diagnosis. This finding seems to strengthen the concept that in the natural history of ARC and AIDS a short, transient activation of the T-cell compartment does occur and precedes the onset of T4 cytolysis (Baroni et al 1985).…”

“…The disintegration of follicular dendritic cells, so monotonously observed throughout the series, might be related to direct or indirect damage of these cells by retrovirus-like particles, which have recently been observed lying between their cytoplasmic processes (Baroni et al 1985, Tenner-Racz et al 1985, Warner & Uno 1985. Furthermore, they might partially be responsible for the profound immunological alterations observed in germinal centres.…”

“…1983, Doming0 & Chin 1983, Guarda et al 1983, Ioachim, Lerner & Tapper 1983a, b, Modlin et al 1983, Hansmann et al 1984, Meyer et af. 1984, Millard 1984, Amberson et al 1985, Baroni et al 1985, Burns, Wood & Dorfman 1985, Chan etal. 1985, Levineetal.…”

Membranous Nephropathy Associated with Giant Lymph Node Hyperplasia

“…This mechanism has been suggested to explain MN associated with Hodgkin's disease or other malignant lymphomas [30,31]. Actual ly, the hypotesis of GLNH as a disreactive immunologi cal disorder [5,6] and the similarity with lymph node changes seen in AIDS patients with systemic lymphadenopathy [32,33] support this assumption.…”

Blood vessels in human immunodeficiency virus‐related lymphadenopathy: high endothelial venules and lymphocyte migration

“…The presence of proliferative vascular changes in HIV-related PGL is generally acknowledged (6, 8,16,17,18,19,20). The invasion of the follicles by HEV-like vessels is regarded as a distinct feature, and the migration of T8 lymphocytes via these vessels into the follicles may be of significance in the pathogenesis of the disorder (1). According to a recent comprehensive survey, the vascular changes seen in HIV-related PGL need to be further evaluated both quantitatively and qualitatively (1 8).…”