[Neuropathologic findings in 13 deceased patients with acquired immunologic deficiency syndrome]

The neuropathological findings in 13 patients with the acquired immune deficiency syndrome (AIDS) and with AIDS related complex (ARC) are reported. Six patients presented with neurological symptoms, whereas autopsy revealed CNS involvement in nine cases. Four patients showed neither neurological nor neuropathological abnormalities. The most frequent neuropathological diagnoses were toxoplasma encephalitis (4 cases) and multiple or solitary cerebral necroses (3 cases). Long tract degeneration of the spinal cord was found in 2 cases. Cytomegalovirus infection, progressive multifocal leukoencephalopathy, primary lymphoma of the CNS, infiltration of the leptomeninges by plasmocytoma cells and a solitary metastasis of a bronchial carcinoma were diagnosed in one case each. Subacute leukoencephalitis, mentioned frequently in the literature, was not present in this material. In one case, however, status spongiosus and gliosis was found in the cortex and basal ganglia. As similar spongy changes can be seen in mice infected experimentally with retroviruses, a pathogenetic role of the human T-cell lymphotropic/leukaemia virus type III (HTLV-III) cannot be ruled out. Astrogliosis and hypertrophy of astrocytes were found in nine cases. Morphometrically, the number of astrocytes was significantly higher in AIDS patients than in control cases which were selected randomly on grounds of comparable age. Whether this finding bears some relationship with HTLV-III encephalopathy remains open to further investigation. Glial nodules were found in four cases; according to silver impregnation they were composed of microglial elements.