[Neuropathology of non conventional infectious agents or prions]

The neuropathological diagnosis of infections by non conventional agents relies on four lesions: astrocytic gliosis (cell hypertrophy and proliferation) usually contrasting with absent mononuclear cell infiltrates (lymphocytes, monocytes-macrophages, and/or microglia) revealed by conventional techniques, and neuronal loss in the most affected areas are little specific findings. Amyloid plaques that are inconstantly found, and spongiosis of gray matter, a characteristic and very frequent finding, are most specific. PrP immunohistochemistry brings additional data. The main diagnostic difficulties are emphasized, and guidelines for Pathological studies are recalled.