Immunohistochemical characterization of multinucleated giant cells in the brain of a Japanese AIDS patient

In an autopsy case of a 35-year-old Japanese hemophiliac with acquired immune deficiency syndrome (AIDS), many multinucleated giant cells (MGCs) were observed throughout the central nervous system. Immunohistochemically, MGCs possessed surface and cytoplasmic macrophage antigens expressed in the late stage of differentiation indicating them to be macrophages in the terminal stage of differentiation. Fine nuclear extensions connecting one nucleus (or lobe) to another were often observed in the MGCs. This feature was interpreted as multilobulation and considered to be a morphological characteristic of MGCs in AIDS encephalopathy. Similarity between MGCs in AIDS encephalopathy and highly lobulated lymphocytes in adult T cell leukemia is discussed.