Michalany J, Mattos A L, Michalany N S, Filie A C, Montezzo L C
Ann Pathol. 1987;7(1):15-24.
According to the 15 autopsies performed at the Department of Pathological Anatomy, Escola Paulista de Medicina, São Paulo, Brazil, it was confirmed that acquired immunodeficiency syndrome (AIDS) occurs preferably in young homosexual males, who die in a short period of time of the disease, which leads to a consumptive state verified by cachexia of the cadavers. The most affected organs of this series were the lungs and encephalum, exactly the ones responsible for the immediate cause of death. In this series of autopsies there were 9 types of microorganisms represented by virus, bacteria, fungi, protozoans and two types of tumors, Kaposi's sarcoma and lymphoma of the central nervous system. From the microorganisms, the most frequent was the Cytomegalovirus and, from the tumors, Kaposi's sarcoma. The various types of microorganisms were frequently associated, principally in the central nervous and digestive systems. There was also association of microorganisms with tumors. Besides the lesions produced by microorganisms there were other associated alterations as brown atrophy of neuronia, which was related to the infiltration of cerebral lymphoma, and the lymphocytic depletion of lymphoid organs due to immunological exhaustion. Cellular reaction to microorganisms was practically none, principally with Pneumocystis carinii and Cryptococcus neoformans, the first one behaving as an inert mould in the pulmonary alveoli and the second proliferating freely in tissues. In two cases there was no granulomatous reaction to Mycobacterium tuberculosis. The primary lymphoma of the central nervous system should be interpreted as a microglioma, i.e., a reticulosarcoma of this system according to Hortega's school.
根据在巴西圣保罗保罗医科大学病理解剖学系进行的15例尸检,证实获得性免疫缺陷综合征(艾滋病)主要发生在年轻的同性恋男性中,他们在患病后短时间内死亡,这导致尸体出现恶病质,呈现出消耗状态。该系列中受影响最严重的器官是肺和脑,正是这些器官导致了直接死亡原因。在这一系列尸检中,有9种微生物,分别由病毒、细菌、真菌、原生动物代表,还有两种肿瘤,即卡波西肉瘤和中枢神经系统淋巴瘤。在微生物中,最常见的是巨细胞病毒,在肿瘤中,最常见的是卡波西肉瘤。各种类型的微生物经常相互关联,主要发生在中枢神经系统和消化系统。微生物也与肿瘤有关联。除了微生物产生的病变外,还有其他相关改变,如神经元的褐色萎缩,这与脑淋巴瘤的浸润有关,以及由于免疫耗竭导致的淋巴器官淋巴细胞耗竭。对微生物的细胞反应几乎没有,主要是对卡氏肺孢子虫和新型隐球菌,前者在肺泡中表现为惰性霉菌,后者在组织中自由增殖。在两例病例中,对结核分枝杆菌没有肉芽肿反应。中枢神经系统原发性淋巴瘤应被解释为小胶质细胞瘤,即根据霍特加学派的观点,是该系统的网状肉瘤。