Neuropathology of AIDS in surgical biopsy specimens

In this brief review of the surgical neuropathology of AIDS we have emphasized that, although there are obvious and meaningful similarities between the autopsy descriptions of AIDS-related CNS disease and those we have seen in surgical specimens, there are also some clear differences in terms of which types of lesions are likely to undergo biopsy. It is also clear that the smaller samples allowed by neurosurgical procedures, particularly in stereotaxic biopsies, can limit the expression of the full pathologic pattern of these entities as expected from autopsy evaluations. Nevertheless, useful diagnostic information is readily and routinely obtained when the surgical sampling is carefully planned and when the tissues obtained are properly handled. There is a role, however, a limited one, for frozen sections in intraoperative consultations. The best diagnostic study is a careful perusal of a good hematoxylin and eosin stain, but judicious use of histochemical and immunohistochemical methods can be essential to a proper diagnosis in selected cases.