Neoplastic angioendotheliomatosis (NAE) of the CNS in a patient with AIDS subacute encephalitis, diffuse leukoencephalopathy and meningo-cerebral cryptococcosis

A 12-year-old, hemophilic boy died with acquired immune deficiency syndrome (AIDS) after a clinical course characterized by progressive psycho-organic syndrome and opportunistic infections. Postmortem neuropathological examination revealed a cerebral form of neoplastic angioendotheliomatosis (NAE),...

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Bibliographic Details
Published inClinical neuropathology Vol. 9; no. 6; p. 284
Main Authors Dozić, S, Suvaković, V, Cvetković, D, Jevtović, D, Skender, M
Format Journal Article
LanguageEnglish
Published Germany 01.11.1990
Subjects
AIDS Dementia Complex - pathology
Biomarkers, Tumor - analysis
Brain - pathology
Brain Neoplasms - pathology
Child
Cryptococcosis - pathology
Endothelium, Vascular - pathology
Hemangioendothelioma - pathology
Humans
Immunoenzyme Techniques
Leukoencephalopathy, Progressive Multifocal - pathology
Male
Meningitis - pathology
Myelin Sheath - ultrastructure
Neoplastic Cells, Circulating
Neuroglia - pathology
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Summary:A 12-year-old, hemophilic boy died with acquired immune deficiency syndrome (AIDS) after a clinical course characterized by progressive psycho-organic syndrome and opportunistic infections. Postmortem neuropathological examination revealed a cerebral form of neoplastic angioendotheliomatosis (NAE), leukoencephalopathy, giant cell encephalitis and meningo-cerebral cryptococcosis. The most unusual finding was the presence of proliferated neoplastic cells within lumina of some blood vessels throughout the central nervous system (CNS). These cells displayed cytologic features of malignancy and stained positively for common leukocyte antigen. Coronal sections showed diffuse cerebral and cerebellar leukoencephalopathy with most pronounced loss of myelin and axons in deep white matter, while the subcortical arcuate fibers and the corpus callosum were partially spared. In these areas numerous small foci of severe myelin loss were present. Microglial nodules and distinctive multinucleated giant cells (MGC) were numerous. Intracytoplasmic and intranuclear acidophilic inclusions were found in a few multinuclear and mononuclear cells. Close contact between mononuclear and multinuclear cells suggesting their fusion was also observed. As far as we know this is the first case of NAE encountered in AIDS, one of the rare primary cerebral forms and the youngest reported case of NAE up to now. This case could be considered as one proof more that NAE is a special form of malignant lymphoma.
ISSN:0722-5091