Document 0202
 DOCN  M9460202
 TI    Granulomatous response to Pneumocystis carinii in patients infected with
       HIV.
 DT    9404
 AU    Kadakia J; Kiyabu M; Sharma OP; Boylen T; Pulmonary and Critical Care
       Medicine Division, USC School of; Medicine, Los Angeles 90003.
 SO    Sarcoidosis. 1993 Mar;10(1):44-9. Unique Identifier : AIDSLINE
       MED/94181943
 AB    Pneumocystis carinii is the most frequent manifestation of the acquired
       immune deficiency syndrome. Typical histologic findings include foamy,
       acellular eosinophilic intra-alveolar exudate in which the cysts of the
       organisms are readily demonstrated with silver stains. Granuloma
       formation is rare. Only nine such cases have been described in the
       English literature. We reviewed 400 transbronchial biopsies done in
       patients suspected of having pneumocystis pneumonia at our institution
       between the period of 1987-1990. Of the 320 biopsy specimens with
       Pneumocystis carinii identified, 17 cases had granulomatous inflammation
       with or without Pneumocystis carinii present. All cultures for
       tuberculosis and fungi were negative during initial admission and follow
       up in fifteen cases. One was later found to have tuberculosis and
       another about 6 months later histoplasmosis, when rebronchoscoped for
       suspicion of recurrent Pneumocystis infection. None of our patients had
       clinical evidence for sarcoidosis or hypersensitivity pneumonitis. We
       believe that granulomatous pneumonitis should be included in the list of
       pulmonary complications associated with Pneumocystis carinii pneumonia.
       Clinical significance and immunologic nature remains unexplained.
 DE    Adult  AIDS-Related Opportunistic Infections/*PATHOLOGY  Biopsy  Female
       Granuloma/*PATHOLOGY  Human  Lung/*PATHOLOGY  Male  Middle Age
       Pneumonia, Pneumocystis carinii/*PATHOLOGY  JOURNAL ARTICLE

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