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Progressive multifocal leukoencephalopathy: cavitary white matter lesions

Caroline Raasch Alquist1, Robin McGoey, Luis Del Valle

  • 1Department of Pathology, Louisiana State University Health Sciences Center, New Orleans, USA.

The Journal of the Louisiana State Medical Society : Official Organ of the Louisiana State Medical Society
|February 26, 2013
PubMed

Insights

Progressive Multifocal Leukoencephalopathy (PML), a severe brain condition caused by JCV virus, affects immunocompromised individuals. This photo showcases characteristic cavitary lesions, highlighting the disease's aggressive nature.

Area of Science:

  • Neurology
  • Virology
  • Radiology

Background:

  • Progressive Multifocal Leukoencephalopathy (PML) is a fatal demyelinating disease of the central nervous system.
  • It is caused by the opportunistic neurotropic Polyomavirus JCV and primarily affects immunocompromised individuals, including those with AIDS.
  • Clinical manifestations include cognitive decline, motor deficits, and speech impairment.

Observation:

  • This case presents a rare example of severe PML with cavitation.
  • Characteristic MRI findings include bilaterally asymmetrical lesions in the subcortical frontal and parietal lobes.
  • Lesions appear as T1 hypo-intensities and T2 hyper-intensities, with gross discoloration and potential cavitation.

Findings:

  • The presented case illustrates striking cavitary lesions indicative of severe PML.
  • The imaging findings align with established radiological markers for PML.
  • The gross pathology reveals characteristic dusky, yellow-brown discoloration.

Implications:

  • This visual documentation aids in understanding the severe manifestations of PML.
  • Recognizing these lesions is crucial for timely diagnosis and management, despite the lack of specific treatments.
  • The case underscores the devastating impact of JCV in immunocompromised patients.

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