THE THYROID IN ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Forty-seven thyroids obtained at autopsy from patients with acquired i mmunodeficiency syndrome (AIDS) with no clinical manifestations of thy roid disease were analyzed systematically in order to determine the fr equency and the major pathological characteristics of thyroid involvem ent in these individuals. The glands were obtained from 38 men and 9 w omen aged (on average) 33.6 yr. The specimens were weighed, measured, and evaluated after fixation in formalin. Histological examination was performed on at least 10 macroscopically normal and altered areas. Th e anatomopathological lesions detected in 29 glands (61.7%) were chron ic nonspecific focal inflammation (48.2%); mycobacteriosis and colloid goiter (17.2%); histoplasmosis, cryptococcosis, and lipomatosis (13.7 %), and paracoccidioidomycosis and hyperplastic nodules (3.4%). Althou gh thyroid disease had not been clinically diagnosed, thyroid involvem ent was elevated (61.7%) and in 14 cases (29.7%) it was related to the immunodeficiency, with mycobacteria being the most common opportunist ic agents. There appears to be no report of the association of lipomat osis with AIDS, although this was a frequent finding in the present st udy (13.7%), exceeding by far the rates reported in the literature (1- 2%). Thus, thyroid lesions are frequent in AIDS patients, occurring in two thirds of the patients studied, especially those with disseminate d infection.