[Bone marrow changes at several stages of HIV infection, studied on bone marrow biopsies in 85 patients]

Bone marrow biopsies from eighty-five patients with different stages of HIV infection were reviewed. Biopsies were generally indicated to evaluate peripheral blood abnormalities, but suspicion of lymphoma and other specific pathologies was another important indication. The histopathological features are described and are often suggestive of HIV infection but non-specific. Hypercellularity (72.9%), dysmyelopoiesis (78.8%), plasma cell hyperplasia (97.7%), lymphoid infiltration (27%) and histiocytosis with or without granulomata (11.7%) were the most striking abnormalities. Other frequent features include: increased stainable iron deposits, venous stasis and serous atrophy (gelatinous transformation). Marrow hypoplasia is rather infrequent (28.2%) and usually a terminal event of AIDS. Bone marrow biopsies revealed opportunistic and neoplastic complications in seven cases, with demonstration of pathogens in four cases (Mycobacterium avium, Cryptoccocus neoformans, Toxoplasma gondii and Leishmania donovanii) and malignant lymphomas in three other cases (one Burkitt's lymphoma and two Hodgkin's disease). Bone marrow biopsy provides useful information for the diagnosis and prognosis of HIV infection and for the diagnosis of complications.