Pontocerebellar Progressive Multifocal Leukoencephalopathy. Radiological, Clinical, Histological and Immunohistochemical Findings in a Hematological Patient  

作　　者：Javier Ortiz Juan Carlos Paniagua Isidro Cavaco Raquel Rivas Andrea Jimenez Luis Chinchilla Elisa Muñoz María Dolores Ludeña Javier Ortiz;Juan Carlos Paniagua;Isidro Cavaco;Raquel Rivas;Andrea Jimenez;Luis Chinchilla;Elisa Muñoz;María Dolores Ludeña(Departamento de Biología Celular y Patología, Universidad de Salamanca (USAL), Salamanca, Spain;Servicio de Anatomía Patológica, Hospital Universitario de Salamanca, Salamanca, Spain;Servicio de Radiodiagnóstico, Hospital Universitario de Salamanca, Salamanca, Spain)

机构地区：[1]Departamento de Biología Celular y Patología, Universidad de Salamanca (USAL), Salamanca, Spain [2]Servicio de Anatomía Patológica, Hospital Universitario de Salamanca, Salamanca, Spain [3]Servicio de Radiodiagnóstico, Hospital Universitario de Salamanca, Salamanca, Spain

出　　处：《Open Journal of Pathology》2023年第4期177-183,共7页病理学期刊（英文）

摘　　要：Objective: To describe the radiological, histological and immunohistochemical findings in a case of Progressive Multifocal Leukoencephalopathy (PML) affecting the cerebellar peduncles in a patient with chronic lymphocytic leukemia. Patient and Methods: Magnetic Resonance Imaging (MRI), histological picture (H.E., Kluver-Barrera) and immunohistochemical picture (GFAP, neurofilaments, CD68, JC virus) were obtained. Results: 1) Magnetic resonance imaging: Asymmetric and progressive lesions on middle cerebellar peduncles, that were hyperintense in T2/FLAIR, extended towards the pons, had no mass effect and were unmodified after intravenous contrast. 2) Histology: Marked reactive gliosis with cytopathic changes suggesting viral infection, plus demyelination areas with axonal preservation. 3) Immunohistochemistry: Marked positivity for viral (polyoma and JC virus) markers in glial cells showing cytopathic changes. Conclusions: The importance of histological and immunohistochemical diagnosis in everyday assistance;of the collaboration between clinicians, radiologists and pathologists;and the validity of postmortem studies as a key element for research and clinical quality assessment must be stressed.Objective: To describe the radiological, histological and immunohistochemical findings in a case of Progressive Multifocal Leukoencephalopathy (PML) affecting the cerebellar peduncles in a patient with chronic lymphocytic leukemia. Patient and Methods: Magnetic Resonance Imaging (MRI), histological picture (H.E., Kluver-Barrera) and immunohistochemical picture (GFAP, neurofilaments, CD68, JC virus) were obtained. Results: 1) Magnetic resonance imaging: Asymmetric and progressive lesions on middle cerebellar peduncles, that were hyperintense in T2/FLAIR, extended towards the pons, had no mass effect and were unmodified after intravenous contrast. 2) Histology: Marked reactive gliosis with cytopathic changes suggesting viral infection, plus demyelination areas with axonal preservation. 3) Immunohistochemistry: Marked positivity for viral (polyoma and JC virus) markers in glial cells showing cytopathic changes. Conclusions: The importance of histological and immunohistochemical diagnosis in everyday assistance;of the collaboration between clinicians, radiologists and pathologists;and the validity of postmortem studies as a key element for research and clinical quality assessment must be stressed.

关 键 词：Progressive Multifocal Leukoencephalopathy JC Virus IMMUNOHISTOCHEMISTRY 

分 类 号：R73[医药卫生—肿瘤]