The Pathology of Extrapulmonary Tuberculosis in HIV Positive Adults: An Autopsy study.

Abstract

An autopsy study of the pathology of extra pulmonary tuberculosis in HIV/AIDS infection has not been carried out at Mulago Hospital before yet tuberculosis is assuming epidemic proportions in this era of HIV/AIDS and s responsible for significant mortality. This preliminary report describes a descriptive cross-sectional autopsy study of 86 cases of adult HIV positive cadavers with extra pulmonary tuberculosis. Autopsy examinations were done, the organs sampled and tissues obtained processed for histopathology using routine H&E and ZN stains. The results show that TB in AIDS is widely disseminated and associated with a significant mortality. The diagnosis of EPTB is difficult because the manifestations are protean and non-specific. The histological patterns are mostly a typical and characterized by areas of caseous necrosis with much nuclear debri, no surrounding epithelioid cells nor Longhan’s gaint cells, abundant AAFB’s and a scanty lymphocytic infiltrate. Most of the tuberculosis is undetected clinically. The results are discussed and compared with those obtained in studies elsewhere in the world particularly sub-Saharan Africa.