Histopathologic spectrum of AIDS-associated lesions in Maharaj Nakorn Chiang Mai Hospital.

HIV infection resulting in AIDS is a multisystemic disease. The authors report their findings from a study of the histopathological alterations in various organs and the presence of AIDS-associated lesions in 86 biopsy and 29 necropsy specimens of AIDS patients at Maharaj Nakorn Chiang Mai Hospital Thailand. Malignant lymphomas presenting in 4% of cases with development of extensive extranodal lymphomatous involvement from the outset was the most common cancer seen in the study. The authors also report the first case of T-lymphoblastic lymphoma with a picture of acute lymphoblastic leukemia (T-ALL). Tuberculosis presented in 34% of cases and was therefore the most common opportunistic infection seen in tissue sections. The majority of tissue biopsies revealed poorly organized granulomas and extensive necrosis with numerous bacilli. Penicilliosis in 20% of cases appeared to be the most common cutaneous lesion with multiple organ involvement. The involved organs showed a partially anergic tissue reaction characterized by poorly formed granulomas with diffuse infiltrate of fungi-laden macrophages and lymphoid cell depletion. The authors note that the organism must be distinguished from Histoplasma capsulatum and other yeast-form fungi. Co-existing cytomegalovirus and P. carinii infections were the predominant findings in lung necropsy specimens from pediatric patients who died from AIDS. A major pathologic feature in the group was diffuse alveolar damage stage II-III with heavy loads of organism and extensive lymphoplasmacytic infiltration.