AN IMMUNOHISTOLOGICAL APPROACH TO PERSISTENT LYMPHADENOPATHY AND ITS RELEVANCE TO AIDS

  • 1 January 1985
    • journal article
    • research article
    • Vol. 59  (2) , 257-266
Abstract
Recent evidence has shown that not only acquired immune deficiency syndrome (AIDS) but also the majority of unexplained persistent, generalized lymphadenopathy (PGL) are related to HTLV-III/LAV [human T cell leukemia virus type 3-lymphadenopathy associated virus] infections. Eleven patients with PGL (10 homosexual males and 1 heterosexual hemophiliac) were studied by immunohistology using monoclonal antibodies to dendritic reticulum cells of the germinal center T and B lymphocyte subsets, plasma cells and factor VIII, as an endothelial marker. In 6 cases only follicular and paracortical hyperplasia was detected, while in 5 other cases destruction of the dendritic reticulum cell network was seen with this sensitive method. This early destruction may explain the release of activated B cells into the circulation and prove to be an ominous prognostic sign, as it appears to correlate with prodromal symptoms. In 4 of 11 cases the depletion of T4+ cells in the paracortex was not as severe as in the blood, indicating that T4+ cells may preferentially settle in tissues at the time of T4 lymphopenia. Germinal centers also contained a patchy infiltration of T8+ cells. A patient with Kaposi''s sarcoma did not show germinal center destruction but did reveal extensive plasma cell infiltrates. Immunohistology may contribute to the definition of prognosis and analysis of disease progression in patients with PGL.