A 44-Year-Old Man with a History of Advanced HIV Is

A 44-year-old man with a history of advanced HIV is brought to the office by his family due to progressive cognitive decline.  Over the last several years he has had worsening memory deficits and difficulty carrying out simple mental tasks.  The patient has had no headaches, slurred speech, muscle weakness, or changes in vision.  He was diagnosed with HIV 7 years ago, but his medical follow-up and treatment compliance have been poor.  The patient does not use tobacco, alcohol, or illicit drugs.  Vital signs are normal.  He has difficulty with delayed recall as well as several executive function tasks.  The remainder of his neurologic examination is unremarkable.  Two weeks later, he dies from severe pneumonia and respiratory failure.  Which of the following histopathologic findings would most likely be found on biopsy of this patient's brain?

A) Amyloid deposits in the cortical blood vessels
B) Congo red staining plaques in the hippocampus
C) Eosinophilic, round, cytoplasmic neuronal inclusions
D) Microglial nodules and multinucleated giant cells
E) Profound neuronal loss in the caudate nucleus
F) Slit-like white matter cavities with surrounding gliosis

Correct Answer:

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