Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection

J. H. Lewis, J. T. Sundeen, G. L. Simon, R. S. Schulof, Gary S Wand, R. L. Gelfand, H. Miller, C. T. Garrett, F. S. Jannotta, J. M. Orenstein

Research output: Contribution to journalArticle

Abstract

The association of disseminated magnesium silicate talc granulomatosis and acquired immunodeficiency syndrome is reported in a male homosexual who used intravenous drugs and who died of overwhelming cytomegalovirus (CMV) infection. Autopsy findings included widespread deposition of talc crystals in the lungs, liver, lymph nodes, bone marrow, and spleen. Typical CMV inclusions were seen in the lungs, kidneys, adrenal glands, gastrointestinal tract, and right eye. There was no evidence of malignancy. Analysis of peripheral blood neutrophil function revealed impaired chemotaxis and chemokinesis, but opsonophagocytosis had remained normal. The CMV infection in the small bowel was extensive and resulted in severe destruction of the muscularis propria and neural plexi, leading to marked dilatation and persistent diarrhea. The terminal course was marked by intractable hypotension, pneumonitis, and malnutrition, which could be attributed respectively to CMV involvement of the adrenal glands, lungs, and small bowel. The etiology and possible role of systemic talc granulomatosis in the development of immunosuppressive illness is reported herein.

Original languageEnglish (US)
Pages (from-to)147-150
Number of pages4
JournalArchives of Pathology and Laboratory Medicine
Volume109
Issue number2
StatePublished - 1985
Externally publishedYes

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Talc
Cytomegalovirus Infections
Acquired Immunodeficiency Syndrome
Adrenal Glands
Cytomegalovirus
Lung
Chemotaxis
Immunosuppressive Agents
Malnutrition
Hypotension
Gastrointestinal Tract
Dilatation
Autopsy
Diarrhea
Pneumonia
Neutrophils
Spleen
Lymph Nodes
Bone Marrow
Kidney

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection. / Lewis, J. H.; Sundeen, J. T.; Simon, G. L.; Schulof, R. S.; Wand, Gary S; Gelfand, R. L.; Miller, H.; Garrett, C. T.; Jannotta, F. S.; Orenstein, J. M.

In: Archives of Pathology and Laboratory Medicine, Vol. 109, No. 2, 1985, p. 147-150.

Research output: Contribution to journalArticle

Lewis, JH, Sundeen, JT, Simon, GL, Schulof, RS, Wand, GS, Gelfand, RL, Miller, H, Garrett, CT, Jannotta, FS & Orenstein, JM 1985, 'Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection', Archives of Pathology and Laboratory Medicine, vol. 109, no. 2, pp. 147-150.
Lewis, J. H. ; Sundeen, J. T. ; Simon, G. L. ; Schulof, R. S. ; Wand, Gary S ; Gelfand, R. L. ; Miller, H. ; Garrett, C. T. ; Jannotta, F. S. ; Orenstein, J. M. / Disseminated talc granulomatosis. An unusual finding in a patient with acquired immunodeficiency syndrome and fatal cytomegalovirus infection. In: Archives of Pathology and Laboratory Medicine. 1985 ; Vol. 109, No. 2. pp. 147-150.
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AU - Wand, Gary S

AU - Gelfand, R. L.

AU - Miller, H.

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AB - The association of disseminated magnesium silicate talc granulomatosis and acquired immunodeficiency syndrome is reported in a male homosexual who used intravenous drugs and who died of overwhelming cytomegalovirus (CMV) infection. Autopsy findings included widespread deposition of talc crystals in the lungs, liver, lymph nodes, bone marrow, and spleen. Typical CMV inclusions were seen in the lungs, kidneys, adrenal glands, gastrointestinal tract, and right eye. There was no evidence of malignancy. Analysis of peripheral blood neutrophil function revealed impaired chemotaxis and chemokinesis, but opsonophagocytosis had remained normal. The CMV infection in the small bowel was extensive and resulted in severe destruction of the muscularis propria and neural plexi, leading to marked dilatation and persistent diarrhea. The terminal course was marked by intractable hypotension, pneumonitis, and malnutrition, which could be attributed respectively to CMV involvement of the adrenal glands, lungs, and small bowel. The etiology and possible role of systemic talc granulomatosis in the development of immunosuppressive illness is reported herein.

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