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

Abstract

The morphological and immunohistochemical findings in lymph nodes of nine patients with the acquired immunodeficiency syndrome (AIDS) and 81 patients with the AIDS-related complex (ARC) are presented. Three basic histological patterns were observed: follicular hyperplasia (29 cases), mixed hyperplasia (49 cases) and lymphocyte depletion (12 cases). While the first two variants were detected in typical ARC patients, lymphocyte depletion was always associated with AIDS. Immunohistochemistry on frozen sections showed that the number of B-cells varied throughout the series, being higher in the follicular type and significantly lower in the lymphocyte depletion nodes. The content of T-lymphocytes of the helper/inducer (T4) phenotype was reduced in all instances; this reduction was more pronounced in the germinal centres in follicular hyperplasia, while it involved all compartments of the node in the mixed and lymphocyte depletion types. In contrast the cytotoxic/suppressor (T8) subset was increased in the follicular and mixed hyperplasias only. Partial disintegration of the dendritic network in at least some of the follicles could be demonstrated in all lymph nodes. In the follicular and mixed hyperplasias there was a high number of proliferating B-cells in the germinal centres. Our data indicate the usefulness of grading the changes occurring in lymph nodes of patients with ARC and AIDS, and allow speculation as to the pathophysiology of these conditions.

Increased Virus Replication and Virulence after Serial Passage of Human Immunodeficiency Virus Type 2 in Baboons

“…The lymph node pathology in HIV-2-infected animals was similar to that seen in some HIV-2-infected macaques and in HIV-1-infected humans (4,11,12,32,34,35) and was most progressive after the third serial passage (i.e., baboons 11966, 12741, and 12933). In addition, the uneven distribution of follicular dendritic cell-bound HIV is also often seen in cases of HIV-1 infection.…”

“…A hallmark of lymphadenopathy in HIV infection is the breakdown of the germinal centers in lymph nodes known as follicular lysis (35,36,42). This finding can occur in a relatively early phase of HIV infection and corresponds to dendritic trapping of HIV particles in the germinal center.…”

“…Viral RNA was detected in paraffin sections of lymphoid tissue by using a 35 S-labeled antisense probe (Lofstrand Laboratories, Gaithersburg, Md.) (36,42,43).…”

Lymphoid Proliferations Associated With Human Immunodeficiency Virus Infection

“…[11][12][13][14][15] These benign lymph nodes from patients with HIV before HAART treatment did not exhibit static histologic features but, over time, progressed through a series of morphologic patterns, known as florid follicular hyperplasia (FFH), mixed follicular hyperplasia and follicular involution (MX), follicular involution (FI), and lymphocyte depletion, which paralleled the CD4 count and clinical stage of disease. 8,[16][17][18][19][20][21][22][23] Furthermore, these morphologic patterns are a consequence of HIV-infection pathobiology. 8,20,24 Florid follicular hyperplasia, the initial morphology seen in progressive HIV-related benign lymphadenopathy, is characterized by large, irregularly shaped geographic follicles, covering up to two-thirds of the cross-sectional area of the lymph node, surrounded by an attenuated to absent mantle cell zones (Figure 1).…”

Immunopathogenesis of Oropharyngeal Candidiasis in Human Immunodeficiency Virus Infection

“…In addition, the follicular DC network was found to be markedly reduced in Tg mice compared to non-Tg mice (342). An atrophic follicular DC network and smaller numbers of GC were observed early during the course of the AIDS pandemic and were considered one of the pathological hallmarks of the disease (326,336,430,431). The CD4C/HIV Tg mice show this phenotype.…”