The spectrum of pathologic lesions in spleen in patients with acquired immunodeficiency syndrome: Autopsy report of 257 patients
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Date
2024-09
Journal Title
Journal ISSN
Volume Title
Publisher
Wolters Kluwer – Medknow
Abstract
Background: Human immunodeficiency virus (HIV) infection continues to persist in India over the past three decades. The involvement of the spleen in these patients has a wide array of differentials with opportunistic infections and malignancies. The spectrum of splenic lesions in patients with HIV/AIDS has not been described in the Indian literature. Materials and Methods: A retrospective study was designed to understand the spectrum of splenic pathology in patients with HIV/AIDS. The specimens of the spleen obtained at autopsy in 257 patients over a period of 29 years were systematically analyzed. Results: Among 257 patients, 197 (77%) were males and 60 (23%) were females with a heterosexual route of transmission in 246 (96%) patients. There were 236 (92%) patients from the pre?highly active anti?retroviral therapy era, while 21 (8%) patients had received highly active anti?retroviral therapy for a short duration. The most frequent splenic pathology identified was tuberculosis, noted in 135 (52%) patients, manifesting as military lesions (119 patients, 46%), tuberculous abscesses (13 patients, 5%), and tuberculosis associated with splenic infarcts (03, 1%) patients. The other pathologies noted were cryptococcosis in 17 (7%) patients, malarial infection in 13 (5%) patients, and cytomegalovirus infection in 01 (0.5%) patient. The other findings identified were chronic passive venous congestion, perivascular fibrosis, hemosiderosis, and amyloidosis. In addition, absence or depletion of lymphocyte was noted in 98 (38%) patients and in 4 (1.5%) patients diffuse large B?cell lymphoma was found. Conclusions: Patients with HIV/AIDS presenting with splenic lesions have a wide array of differentials, such as tuberculosis, opportunistic infection, and the lymphoma. This study provides a better insight into the splenic lesions in patients with AIDS in India.
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Keywords
AIDS, Autopsy, cryptococcosis, spleen, tuberculosis
Citation
Lanjewar Dhaneshwar N., Kavatkar Anita N. . The spectrum of pathologic lesions in spleen in patients with acquired immunodeficiency syndrome: Autopsy report of 257 patients. Indian Journal of Pathology & Microbiology. 2024 Sep; 67(3): 553-558