Tags

Type your tag names separated by a space and hit enter

Histopathology of cerebral toxoplasmosis in human immunodeficiency virus infection: a comparison between patients with early-onset and late-onset acquired immunodeficiency syndrome.

Abstract

We reviewed the histological features of untreated toxoplasmosis in 18 cases with the acquired immunodeficiency syndrome (AIDS), eight of which were surgical biopsies and 10 of which were autopsy specimens. The results were compared according to the clinical status of the patient at the time the diagnosis of toxoplasmosis was made (early-onset v late-onset AIDS) and according to the source of the specimen (surgical biopsy specimen v autopsy specimen). Cerebral toxoplasmosis was the AIDS-defining illness in half of the cases (six surgical biopsy specimens and three autopsy specimens). Inflammation in these cases was moderate in 44% and severe in 56%. Fibrous capsules were found in five cases. Lymphocytes and plasma cells were more prominent than neutrophils. Cerebral toxoplasmosis developed in or was part of the terminal AIDS illness in the remaining nine cases (two surgical biopsy specimens and seven autopsy specimens). In this group inflammation was sparse in 44%, moderate in 55%, and severe in only 11%. Fibrous capsules were usually absent and neutrophils were the predominant cell type. Comparisons between surgical biopsy specimens and autopsy specimens showed moderate to severe inflammation and frequent fibrous encapsulation in all of the former specimens but only in those autopsy specimens in which toxoplasmosis was the initial manifestation of AIDS. Thus, this study demonstrates varied neuropathological patterns of untreated cerebral toxoplasmosis in patients with AIDS and correlates the inflammatory response in the brain with the clinical stage of the patient's human immunodeficiency syndrome (HIV) infection. Inflammation and fibrous encapsulation were common only in patients with early-onset AIDS in whom cerebral toxoplasmosis was the first manifestation of the illness. This study highlights important differences between the histology of this infection at surgical biopsy and at autopsy, and stresses the need to consider toxoplasma as a potential cause of encapsulated brain abscesses.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Pathology, University of Miami School of Medicine, FL 33136.

    ,

    Source

    Human pathology 25:10 1994 Oct pg 1091-7

    MeSH

    Acquired Immunodeficiency Syndrome
    Adult
    Biopsy
    Female
    Fibrosis
    Histocompatibility Antigens Class I
    Histocompatibility Antigens Class II
    Humans
    Leukocytes
    Male
    Middle Aged
    Time Factors
    Toxoplasmosis, Cerebral

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    7927315

    Citation

    Falangola, M F., et al. "Histopathology of Cerebral Toxoplasmosis in Human Immunodeficiency Virus Infection: a Comparison Between Patients With Early-onset and Late-onset Acquired Immunodeficiency Syndrome." Human Pathology, vol. 25, no. 10, 1994, pp. 1091-7.
    Falangola MF, Reichler BS, Petito CK. Histopathology of cerebral toxoplasmosis in human immunodeficiency virus infection: a comparison between patients with early-onset and late-onset acquired immunodeficiency syndrome. Hum Pathol. 1994;25(10):1091-7.
    Falangola, M. F., Reichler, B. S., & Petito, C. K. (1994). Histopathology of cerebral toxoplasmosis in human immunodeficiency virus infection: a comparison between patients with early-onset and late-onset acquired immunodeficiency syndrome. Human Pathology, 25(10), pp. 1091-7.
    Falangola MF, Reichler BS, Petito CK. Histopathology of Cerebral Toxoplasmosis in Human Immunodeficiency Virus Infection: a Comparison Between Patients With Early-onset and Late-onset Acquired Immunodeficiency Syndrome. Hum Pathol. 1994;25(10):1091-7. PubMed PMID: 7927315.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Histopathology of cerebral toxoplasmosis in human immunodeficiency virus infection: a comparison between patients with early-onset and late-onset acquired immunodeficiency syndrome. AU - Falangola,M F, AU - Reichler,B S, AU - Petito,C K, PY - 1994/10/1/pubmed PY - 1994/10/1/medline PY - 1994/10/1/entrez SP - 1091 EP - 7 JF - Human pathology JO - Hum. Pathol. VL - 25 IS - 10 N2 - We reviewed the histological features of untreated toxoplasmosis in 18 cases with the acquired immunodeficiency syndrome (AIDS), eight of which were surgical biopsies and 10 of which were autopsy specimens. The results were compared according to the clinical status of the patient at the time the diagnosis of toxoplasmosis was made (early-onset v late-onset AIDS) and according to the source of the specimen (surgical biopsy specimen v autopsy specimen). Cerebral toxoplasmosis was the AIDS-defining illness in half of the cases (six surgical biopsy specimens and three autopsy specimens). Inflammation in these cases was moderate in 44% and severe in 56%. Fibrous capsules were found in five cases. Lymphocytes and plasma cells were more prominent than neutrophils. Cerebral toxoplasmosis developed in or was part of the terminal AIDS illness in the remaining nine cases (two surgical biopsy specimens and seven autopsy specimens). In this group inflammation was sparse in 44%, moderate in 55%, and severe in only 11%. Fibrous capsules were usually absent and neutrophils were the predominant cell type. Comparisons between surgical biopsy specimens and autopsy specimens showed moderate to severe inflammation and frequent fibrous encapsulation in all of the former specimens but only in those autopsy specimens in which toxoplasmosis was the initial manifestation of AIDS. Thus, this study demonstrates varied neuropathological patterns of untreated cerebral toxoplasmosis in patients with AIDS and correlates the inflammatory response in the brain with the clinical stage of the patient's human immunodeficiency syndrome (HIV) infection. Inflammation and fibrous encapsulation were common only in patients with early-onset AIDS in whom cerebral toxoplasmosis was the first manifestation of the illness. This study highlights important differences between the histology of this infection at surgical biopsy and at autopsy, and stresses the need to consider toxoplasma as a potential cause of encapsulated brain abscesses. SN - 0046-8177 UR - https://www.unboundmedicine.com/medline/citation/7927315/Histopathology_of_cerebral_toxoplasmosis_in_human_immunodeficiency_virus_infection:_a_comparison_between_patients_with_early_onset_and_late_onset_acquired_immunodeficiency_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0046-8177(94)90070-1 DB - PRIME DP - Unbound Medicine ER -