Giangaspero F, Scanabissi E, Baldacci M C, Betts C M
Institute of Anatomic Pathology, University of Bologna, Italy.
Acta Neuropathol. 1989;78(6):662-5. doi: 10.1007/BF00691293.
Human immunodeficiency virus (HIV) encephalitis in children with AIDS includes a diffuse white matter disease associated with an inflammatory cell infiltrate that features multinucleated giant cells. Cerebral cortex is relatively preserved and only focal loss of Purkinje cells in the cerebellum has been observed. We describe a case of encephalitis in a child with AIDS in which there was massive and diffuse destruction of the cerebral cortex with severe neuronal loss, marked inflammatory perivascular infiltrate with abundant multinucleated cells and large pleomorphic reactive astrocytes. Similar findings were present in the basal ganglia. Moreover, the cerebellum disclosed a complete loss of Purkinje and granule cells. These findings could not be related to an ischemic mechanism or to an associated opportunistic infection. Electron microscopy showed numerous HIV particles. This case illustrates a different pattern of CNS involvement by HIV and emphasizes the destructive capacity of this neurotropic virus for neural tissue.
患有艾滋病的儿童发生的人类免疫缺陷病毒（HIV）脑炎包括一种与炎性细胞浸润相关的弥漫性白质疾病，其特征为多核巨细胞。大脑皮层相对保留，仅观察到小脑浦肯野细胞局灶性缺失。我们描述了一例患有艾滋病的儿童发生的脑炎病例，该病例中大脑皮层出现大规模弥漫性破坏，伴有严重的神经元丧失、明显的血管周围炎性浸润，有大量多核细胞和大的多形性反应性星形胶质细胞。基底神经节也有类似表现。此外，小脑显示浦肯野细胞和颗粒细胞完全缺失。这些发现与缺血机制或相关的机会性感染无关。电子显微镜检查显示有大量HIV颗粒。该病例说明了HIV累及中枢神经系统的一种不同模式，并强调了这种嗜神经病毒对神经组织的破坏能力。
