File:Aggressive multiple sclerosis (Radiopaedia 24397-24698 D 1).jpg

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Aggressive_multiple_sclerosis_(Radiopaedia_24397-24698_D_1).jpg ‎(514 × 410 pixels, file size: 30 KB, MIME type: image/jpeg)

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Description
  • Radiopaedia case ID: 24397
  • Image ID: 4504880
  • Plane projection: Luxol Fast Blue
  • Study description: Brain biopsy
  • Study findings: MACROSCOPIC DESCRIPTION: "Right parietal brain biopsy":  Multiple pieces of soft tan tissue up to 5mm MICROSCOPIC DESCRIPTION: Paraffin sections show fragments of cerebral cortex and white matter. Cortex is unremarkable. The white matter is densely infiltrated by foamy macrophages containing granular PAS+/Luxol Fast Blue positive material consistent with myelin breakdown products. Prominent reactive astrocytes are scattered among the macrophage population. T lymphocytes, predominantly CD8+, cells are scattered among the macrophage cell polulation. Smaller numbers of CD4+ T lymphocytes are also present. Macrophages and activated microglia show strong surface expression of MHC Class I antigen. Luxol Fast Blue staining shows loss of myelin and Bodian silver impregnation shows axonal fragmentation and formation of axonal spheroids indicating recent axonal injury. The overall features are of inflammatory demyelination.  No viral inclusion bodies are identified There is no evidence of tumor. Immunostaining for SV-40/JC-virus is NEGATIVE FINAL DIAGNOSIS: "Right parietal brain biopsy":  Inflammatory demyelination with features favoring plaque demyelination rather than ADEM.
  • Modality: Pathology
  • System: Central Nervous System
  • Findings: Extensive predominantly periventricular white matter lesions are present which demonstrate enhancement and restricted diffusion. There is involvement of the corpus callosum. Three lesions are also seen in the thoracic spine (not shown) involving the dorsal columns.
Date Published: 13th Aug 2013
Source https://radiopaedia.org/cases/aggressive-multiple-sclerosis
Author RMH Neuropathology
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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Date/TimeThumbnailDimensionsUserComment
current12:55, 28 April 2021Thumbnail for version as of 12:55, 28 April 2021514 × 410 (30 KB)FæRadiopaedia project rID:24397 (batch #1492-4 D1)

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