Related Experiment Video
Updated: May 13, 2026
09:41
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
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.
Summary
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.
Related Concept Videos
01:22Cerebral Edema ll: Pathophysiology
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
01:23Alzheimer Disease ll: Pathophysiology
Alzheimer disease involves structural changes in the brain that begin long before symptoms appear. The most distinctive features are extracellular neuritic plaques and intracellular neurofibrillary tangles.Neuritic plaques form in the cerebral cortex and around blood vessels. These plaques contain a dense core of beta-amyloid (Aβ)—a toxic protein fragment that clumps outside neurons. The core is surrounded by damaged neuronal extensions, as well as reactive astrocytes and microglia. Abnormal...
01:26Encephalitis ll: Pathophysiology
Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
01:22Dementia l: Introduction
Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...
01:26Brain Abscess l: Introduction
A brain abscess is a focal, intracerebral infection characterized by a localized collection of pus within the brain parenchyma, resulting from microbial invasion and the body’s inflammatory response. It progresses through stages: early and late cerebritis, followed by early and late capsule formation, reflecting tissue destruction, immune response, and eventual encapsulation.Etiology and PathogenesisCausative organisms vary with source and host factors, often involving polymicrobial infections,...