Summary
Ultrastructural studies of cells and tissues in the acquired immunodeficiency syndrome (AIDS) have revealed two distinct cytomembranous inclusions referred to as “tubuloreticular inclusions” (TRI) and “confronting cylindrical cisterns” (CCC). TRI are found most often in leukocytes and endothelial cells in conditions with elevated levels of alpha-interferon, such as viral infections, autoimmune diseases and certain neoplasms. On the other hand, CCC are detected almost exclusively in mononuclear inflammatory cells and are limited to a few conditions, of which AIDS is the most common. CCC have been proposed as an ultrastructural marker for human immunodeficiency virus (HIV) infection. We describe CCC in mononuclear inflammatory cells in the brain of a patient with AIDS. Finding CCC in brain tissue with no other specific feature such as multinucleated giant cells, nevertheless, should alert the neuropathologist to the possibility that the patient might have AIDS.
References
Anders KH, Querra WF, Tomiyasu U, Verity MA, Vinters HV (1986) The neuropathology of AIDS: UCLA experience and review. Am J Pathol 124:537–558
Belman AL, Ultmann MH, Horoupian DS, Novick B, Spiro AJ, Kurtzberg D, Cone-Wesson B (1985) Neurological complications in infants and children with acquired immune deficiency syndrome. Ann Neurol 18:560–566
Budka H (1986) Multinucleated giant cells in brain: a hallmark of the acquired immune deficiency syndrome (AIDS). Acta Neuropathol (Berl) 69:253–258
de la Monte SM, Ho DD, Schooley RT, Hirsch MS, Richardson EP Jr (1987) Subacute encephalomyelitis of AIDS and its relation to HTLV-III infection. Neurology 37:562–569
Dickson DW (1986) Multinucleated giant cells in acquired immunodeficiency syndrome encephalopathy: origin from endogenous microglia? Arch Pathol Lab Med 110:967–968
Dickson DW, Suzuki KI, Kanner R, Weitz S, Horoupian DS (1986) Cerebral granular cell tumor: immunohistochemical and electron microscopic study. J Neuropathol Exp Neurol 45:304–314
Gabuzda DH, Ho DD, de la Monte SM, Hirsch MS, Rota TR, Sobel RA (1986) Immunocytochemical identification of HTLV-III antigen in brains of patients with AIDS. Ann Neurol 20:289–295
Gartner S, Markovits P, Markovits DM, Kaplan MH, Gallo RC Popovic M (1986) The role of mononuclear phagocytes in HTLV/LAV infection. Science 233:215–219
Gartner S, Markovits P, Markovits DM, Betts RF, Popovic M (1986) Virus isolation from and identification of HTLV/LAV-producing cells in brain tissue from a patient with AIDS. JAMA 256:2365–2371
Ho DD, Pomerantz RJ, Kaplan JC (1987) Pathogenesis of infection with human immunodeficiency virus. N Engl J Med 317:278–286
Jackson D, Tabor E, Gerety R (1979) Acute non-A, non-B hepatitis: specific ultrastructural alterations in endoplasmic reticulum of infected hepatocytes. Lancet I:1249–1250
Klatzmann D, Chapagne E, Chamaret S, Gruest J, Guetard D, Hercent T, Gluckman J-C, Montagnier L (1984) T-lymphocyte T4 molecule behaves as the receptor for human retrovirus LAV. Nature 312:767–768
Kleihues P, Lang W, Burger PC, Budka H, Vogt M, Maurer R, Lüthy R, Siegenthaler W (1985) Progressive diffuse leukoencephalopathy in patients with acquired immune deficiency syndrome (AIDS). Acta Neuropathol (Berl) 68:333–339
Kostianovsky M, Orenstein JM, Schaff Z, Grimley PM (1987) Cytomembranous inclusions observed in acquired immunodeficiency syndrome. Arch Pathol Lab Med 111:218–223
Levy RM, Bredesen DE, Rosenblum ML (1985) Neurological manifestations of the acquired immunodeficiency syndrome (AIDS): experience at UCSF and review of the literature. J Neurosurg 62:475–495
Maddon PJ, Dalgleish AG, McDougal JS, Clapham PR, Weiss RA, Axel R (1986) The T4 gene encodes the AIDS virus receptor and is expressed in the immune system and the brain. Cell 47:333–348
Mannoji H, Yeger H, Becker LE (1986) A specific histochemical marker (lectin Ricinus communis agglutinin-I) for normal human microglia, and application to routine histopathology. Acta Neuropathol (Berl) 71:341–343
McDougal JS, Kennedy MS, Sligh JM, Cort SP, Mawle A, Nicholson JKA (1986) Binding of HTLV-III/LAV to T4 + cells by a complex of the 110K viral protein and the T4 molecule. Science 231:382–385
Moskowitz LB, Hensley GT, Chan JC, Gregorios J, Conley FK (1984) The neuropathology of acquired immune deficiency syndrome. Arch Pathol Lab Med 108:867–872
Navia BA, Jordan BD, Price RW (1986) The AIDS dementia complex. I. clinical features. Ann Neurol 19:517–524
Neilsen SL, Petito CK, Urmacher CD, Posner JB (1984) Subacute encephalitis in acquired immune deficiency syndrome: a postmortem study. Am J Clin Pathol 82:678–682
Orenstein JM, Schulof RS, Simon GL (1984) Ultrastructural markers in acquired immune deficiency syndrome. Arch Pathol Lab Med 108:857–859
Orenstein JM, Simon GL, Schulof RS (1985) Ultrastructural markers in circulating lymphocytes of subjects at risk for AIDS. Am J Clin Pathol 84:603–609
Raine CS (1985) Oligodendrocytes and central nervous system myelin. In: Davis RL, Robertson DM (eds) Textbook of neuropathology. Williams & Wilkins Baltimore, pp 92–116
Petito CK, Cho E-S, Lemann W, Navia BA, Price RW (1986) Neuropathology of acquired immunodeficiency syndrome (AIDS): an autopsy review. J Neuropathol Exp Neurol 45:635–646
Prineas JW, Wright RG (1978) Macrophages, lymphocytes and plasma cells in perivascular compartment in chronic multiple sclerosis. Lab Invest 38:409–421
Rich SA (1981) Human lupus inclusions and interferon. Science 213:772–774
Shamato M, Murakami S, Zenke T (1981) Adult T-cell leukemia in Japan: an ultrastructural study. Cancer 47:1804–1811
Sharer LR, Cho E-S, Epstein LG (1985) Multinucleated giant cells and HTLV-III in AIDS encephalopathy. Hum Pathol 16:760
Sharer LR, Epstein LG, Cho ES, Joshi VV, Meyenhofer MF, Rankin LF, Petito CK (1986) Pathologic features of AIDS encephalopathy in children: evidence for LAV/HTLV-III infection of brain. Hum Pathol 17:271–284
Shaw GM, Harper ME, Hahn BH, Epstein LG, Gajdusek DC, Price RW, Navia BA, Petito CK, O'Hara CJ, Groopman JE, Cho E-S, Oleske JM, Wong-Staal F, Gallo RC (1985) HTLV-III infection in brains of children and adults with AIDS encephalopathy. Science 227:177–182
Sidhu GS, Stahl RS, El-Sadr W, Cassai ND, Forrester EM, Zolla-Pazner S (1985) The acquired immunodeficiency syndrome: an ultrastructural study. Hum Pathol 16:377–386
Snider WD, Simpson DM, Nielsen S, Gold JWM, Metroka CE, Posner JB (1983) Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann Neurol 14:403–418
Stoler MH, Eskin TA, Benn S, Angerer RC, Angerer LM (1986) Human T-cell lymphotropic virus type III infection of the central nervous system: a preliminary in situ analysis. JAMA 17:2360–2364
Tourvieille B, Gorman SD, Field EH, Hunkapiller T, Parnes JR (1986) Isolation and sequence of L3T4 complementary DNA clones: expression in T-cells and brain. Science 234:610–614
Vazeux R, Brousse N, Jarry A, Henin D, Marche C, Vedrenne C, Mikol J, Wolff M, Michon C, Rozenbaum W, Bureau J-F, Montagnier L, Brahic M (1987) AIDS subacute encephalitis: identification of HIV-infected cells. Am J Pathol 126:403–410
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Lee, S., Harris, C., Hirschfeld, A. et al. Cytomembranous inclusions in the brain of a patient with the acquired immunodeficiency syndrome. Acta Neuropathol 76, 101–106 (1988). https://doi.org/10.1007/BF00687686
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DOI: https://doi.org/10.1007/BF00687686