Most common site for lymphoma in AIDS patients is
Correct Answer: CNS lesions
Description: Ref Robbins 9/e p254, 8/e p529,7/e p549 Pathogenesis of CNS Involvement The pathogenesis of the neurologic manifestations in AIDS deserves special mention because, in addition to the lymphoid system, the nervous system is a major target of HIV infection. Macrophages and cells belonging to the monocyte-macrophage lineage (microglial cells) are the predominant cell types in the brain that are infected with HIV. The virus is most likely carried into the brain by infected monocytes (thus, brain HIV isolates are almost exclusively of the R5 type). The mechanism of HIV-induced damage of the brain, however, remains obscure. Because neurons are not infected by HIV, and the extent of neuro- pathologic changes is often less than might be expected from the severity of neurologic symptoms, most expes believe that the neurologic deficit is caused indirectly by viral products and soluble factors (e.g., cytokines such as TNF) produced by macrophages and microglial cells. In addition, injury from nitric oxide induced in neuronal cells by gp41 and direct damage of neurons by soluble HIV gp120 have been postulated.
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