[Spectrum of the renal pathology in HIV infection: description of 85 autopsies and clinico-pathologic correlation]. / El espectro de la patología renal en la infección por el VIH: descripción de 85 autopsias y correlación clínico-patológica.

A descriptive cross-sectional study was conducted on the prevalence and histologic characteristics of renal lesions found in the autopsies of 85 patients with HIV infection: also, a retrospective analysis of clinico-biological characteristics in 56 of these patients in order to establish the factors associated with the histological findings. A total of 85 autopsies were made from 1985 to 1993; 50 autopsies (58.8%) showed renal changes: 23 (27%) infections, 13 (15.2%) acute tubular necrosis (ATN), 6 (7%) tumors, 5 (5.8%) intersticial nephritis (IN), 5 (5.8%) nephrocalcinosis (NC), 10 (11.7%) others. In an additional study: group IIc (n = 37, study group with nephropathy) had a higher incidence in the hepatitis B surface marker (HBsAg) than in group Ic (n = 19, control group, without nephropathy) (0 vs 10, p < 0.05). The presence of disseminated mycobacteriosis in the autopsy was significantly higher in the group with nephropathy than in the group without nephropathy (11 vs 1, p < 0.05). No consistent data were observed between the clinical diagnosis of nephropathy and autopsic findings. In summary, a high incidence of nephropathy was found in the autopsies of HIV infected patients, although it was not previously suspected. Renal lesions in autopsies of HIV infected patients had a tubular-intersticial predominance over glomerular lesions. The use of potentially nephrotoxic drugs, the presence of HBsAG, and some opportunist infections apparently influenced on the development of renal lesions among these patients.

Cystic transformation and calcium oxalate deposits in rete testis and efferent ducts in dialysis patients.

The histological study of the testes and epididymides obtained from autopsies of 24 men with chronic renal insufficiency revealed bilateral cystic transformation of the rete testis and efferent ducts in patients who underwent hemodialysis or peritoneal dialysis, but not in patients who did not receive this treatment. The lesion was associated with an accumulation of crystalline calcium oxalate deposits in the lumen of the rete testis and efferent ducts, and in the connective tissue adjacent to these excretory ducts. The rete testis epithelium showed columnar transformation with occasional papillary proliferations. Neither atypias or mitoses were observed. In three specimens, fibrosis and giant cell reactions was also present in the rete testis at the level of crystalline deposits. In three specimens, the caput epididymidis was enlarged, and the efferent ducts showed an increase in both tubular diameter and epithelial height, irregular outline, and development of diverticula. The lesions appeared within 30 months after the onset of dialysis.

Adrenal gland leiomyoma in a child with acquired immunodeficiency syndrome.

An adrenal gland leiomyoma was incidentally found at autopsy in a 2-year-old boy with acquired immunodeficiency syndrome (AIDS). Smooth muscle neoplasms have been described in pediatric AIDS and affect mainly the tracheobronchopulmonary, gastrointestinal, and hepatobiliary systems. An association between Epstein-Barr virus (EBV) and smooth muscle tumors in patients with AIDS has been described. This case is the first leiomyoma to be reported in the adrenal gland of a child with AIDS. EBV genome was demonstrated in the tumor by polymerase chain reaction.

Epithelial-myoepithelial tumor of the bronchus.

A primary bronchial tumor with a histological pattern similar to that of epithelial-myoepithelial tumor of the salivary gland is reported in a 55-year-old woman. The tumor was well delimited, although not encapsulated, and showed a polypoid growth. The tumor was composed of two types of neoplastic cells: epithelial cells displaying tubules and myoepithelial cells that either formed compact masses or surrounded the tubular formations. Immunohistochemical study confirmed positive immunoreaction to both high- and low-molecular-weight cytokeratins in the epithelial cells and positive immunoreaction to vimentin, S-100 protein, and myosin in the myoepithelial cells.

[Terminal ileitis due to cryptosporidium and cytomegalovirus in a patient with AIDS]. / Ileítis terminal por criptosporidium y citomegalovirus en un paciente con SIDA.

Terminal patients with infection by the Human Immunodeficiency Virus (HIV), gastrointestinal affection is frequently observed, caused by many etiological agents. However, the affection of the terminal ileon is and generally associated to cytomegalovirus (CMV), intracellular Mycobacterium avium (IMA) and Mycobacterium tuberculosis. We present a patient diagnosed of AIDS with clinical signs of chronic diarrhea secondary to terminal ileitis by Cryptosporidium and CMV. We discuss the radiological and hystological findings and the potential pathogenic synergism.