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Amyloid fibrils are aggregates of misfolded proteins.  Under most circumstances, misfolded proteins are either refolded by chaperone proteins or degraded by the proteasome. However, in the case of a mutation or a disease, these proteins can accumulate to form large clusters and often further assemble to form elongated fibers, called fibrils. 
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Updated: Jun 17, 2025

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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[Tumefactive Demyelinating Lesions].

Yuki Mizumoto1, Tetsuya Abe

  • 1Department of Neurology, Yamaguchi Prefectural Grand Medical Center.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|August 8, 2024
PubMed
Summary

Tumefactive demyelinating lesions (TDL) are inflammatory brain lesions that can mimic tumors or infections. Distinguishing TDL from other conditions often requires neuroimaging and biopsy, especially in initial demyelinating episodes.

Area of Science:

  • Neuroscience
  • Neurology
  • Pathology

Background:

  • Tumefactive demyelinating lesions (TDL) are inflammatory demyelinating lesions.
  • TDL can occur during treatment for multiple sclerosis or as an initial demyelinating event.
  • Diagnosing TDL can be challenging, especially when presenting as a first episode without prior history.

Purpose of the Study:

  • To review the concept, epidemiology, diagnosis, and treatment of TDL.
  • To highlight the diagnostic challenges of TDL, particularly in early demyelinating episodes.
  • To emphasize the role of biopsy in differentiating TDL from neoplastic or infectious conditions.

Main Methods:

  • Literature review of TDL concept, epidemiology, diagnosis, and treatment.
  • Analysis of diagnostic criteria and imaging findings for TDL.

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  • Discussion of biopsy's role in differential diagnosis.

    • Main Results:

    • TDL definition and presentation variations outlined.
    • Diagnostic difficulties in early TDL cases emphasized.
    • Importance of neuroimaging and biopsy for accurate diagnosis highlighted.

    Conclusions:

    • TDL diagnosis requires careful consideration, especially in initial presentations.
    • Distinguishing TDL from tumors and infections often necessitates biopsy.
    • Comprehensive understanding of TDL epidemiology, diagnosis, and treatment is crucial.