Document Detail

Alveolar damage in AIDS-related Pneumocystis carinii pneumonia.
MedLine Citation:
PMID:  9149569     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Pneumocystis carinii pneumonia is the most common and serious of the pulmonary complications of AIDS. Despite this, many basic aspects in the pathogenesis of HIV-associated P carinii pneumonia are unknown. We therefore undertook a light and electron microscopic study of transbronchial biopsy specimens to compare pathologic features of P carinii pneumonia and other HIV-related lung diseases. DESIGN AND PATIENTS: Thirty-seven consecutive HIV-infected patients undergoing a diagnostic bronchoscopy. RESULTS: P carinii pneumonia was characterized by an increase in inflammation, edema, exudate, fibrosts, type II pneumocyte proliferation, and cellular infiltration of the alveolar wall when compared with other lung diseases (all p < 0.05). Electron microscopy showed apposition of the trophozoite to the type I pneumocyte. Erosion of type I pneumocytes was observed in 13 of 15 patients with P carinii pneumonia, whereas none without P carinii pneumonia had this finding (p < 0.05). Erosion of the type II pneumocyte was not observed. CONCLUSION: Inflammation, interstitial fibrosis, and alveolar epithelial erosion are characteristic features of P carinii pneumonia. The changes may form the pathologic basis for the respiratory failure seen in patients with P carinii pneumonia. Electron microscopy did not show any diagnostie advantage over conventional light microscopy using routine stains.
T L Benfield; P Prentø; J Junge; J Vestbo; J D Lundgren
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Chest     Volume:  111     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-03     Completed Date:  1997-06-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1193-9     Citation Subset:  AIM; IM; X    
Departments of Infectious Diseases and Pathology, EM Division, University of Copenhagen, Hvidovre Hospital, Denmark.
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MeSH Terms
AIDS-Related Opportunistic Infections / pathology*
Bronchoalveolar Lavage Fluid / microbiology
Cell Division
Colony Count, Microbial
Coloring Agents / diagnostic use
Cytoplasm / ultrastructure
Edema / pathology
Epithelium / pathology,  ultrastructure
Exudates and Transudates
Inflammation / pathology
Lung Diseases / pathology
Microscopy, Electron
Middle Aged
Organelles / ultrastructure
Pneumocystis / cytology
Pneumocystis Infections / pathology*
Pulmonary Alveoli / pathology*,  ultrastructure
Pulmonary Fibrosis / pathology
Respiratory Insufficiency / etiology,  pathology
Reg. No./Substance:
0/Coloring Agents

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