[Histopathology of bone marrow biopsy in patients with human immunodeficiency virus infection]

To describe morphology of bone marrow (BM) biopsy in HIV infected patients. To correlate histopathologic findings and clinico-haematological data. To consider the advantages of this method (BM biopsy) in the diagnosis of secondary infectious or tumoural accompanying processes.

One hundred and fourteen BM biopsies of 103 HIV infected patients were retrospectively reviewed. The cases were selected from the records of Pathology Department of Jiménez Díaz-Foundation (from 1984 to 1993). All cases were studied with routine and immunohistochemical (IHQ) techniques against haematopoietic and proliferative markers. Clinico-haematological data were also reviewed.

Ninety per cent of biopsies showed morphological abnormalities: hypercellularity, myeloid hyperplasia and dysplasia of erythroid and megacariocytic series. Reticuline myelofibrosis and reactive lymphoplasmacytosis were also present. IHQ confirms the described histopathologic pattern. Twenty-two per cent of cases showed signs of infectious or tumoural diseases: mycobacteriosis (15%) and lymphomas (7%). Clinical manifestations were correlated with significant alterations in the BM: fever with hypercelullarity, constitutional syndrome and myelofibrosis with zidovudine therapy and infections with myelodysplasia.

Cytology, myelofibrosis and abnormal pattern of BM biopsies in HIV infected patients are characteristic: "the so-called AIDS BM pattern" as BM is a target organ in the HIV-related infections. BM biopsies are a good method to demonstrate stage of HIV disease and accompanying infectious or tumoural processes.