Systemic disease Flashcards
What are some opportunistic infections in HIV patients
o Pneumocystis jiroveci PCP pneumonia
o CMV especially retina and GIT
I.E. CMV oesophagitis
Stains brown in immunohistochemistry
o Candida
o Tuberculosis and atypical mycobacteria
o Cryptococcus meningitis
o Toxoplasma gondii encephalitis and mass lesions
o JC papovavirus progressive multifocal leukoencephalopathy
o Herpes simplex
o Cryptosporidium, Isospora belli, microsporidia GIT
what tumours occur in HIV
o Kaposi’s sarcoma (HHV-8)
(A) Dermis expanded by a solid tumour
(B) Made of spindle-shaped cells – infiltrated by HHV-8
(C) HHV-8 identified in nuclei of tumour cells
o Lymphoma (systemic [CNS, or body-cavity based], B-cell lymphoma, EBV)
o Other (SSC, anus & cervix, HPV)
what CNS diseases occur in HIV
• Central nervous system diseases
o Progressive encephalopathy = AIDS dementia complex
o Plus, opportunistic infections and tumours
o CNS lymphoma
TB histopathology
o Caseating granulomas – in immunocompetent people
Cavitating TB – predilection to apices of lungs
The granuloma will be caseating (necrotic centres – like cottage cheese)
o Demonstration of acid-fast bacilli
sarcoid histology
o NON-caseating granulomas – collection of macrophages with a cuff of lymphocytes around
o Diagnosed as a diagnosis of exclusion
Amyloid
- Deposition of an abnormal proteinaceous substance in non-branching fibrils, 7.5-10nm diameter
- Always contains P-component
- Beta-pleated sheet structure
- A variety of proteins can take on this conformation
- Resistant to enzymic degradation
amyloid clinical features
o Proteinuria, renal failure Restrictive cardiomyopathy, arrhythmias
o Autonomic neuropathy Carpal tunnel syndrome
o Macroglossia Bleeding on injury
o Also deposited in blood vessels, endocrine organs, liver, spleen
amyliod staining
congo red dye, shows apple green birefringence under polarised light
