[Progressive multifocal leukoencephalopathy localized in the thalamic grey matter in an AIDS-patient]

Area of Science:

• Neurology
• Neurovirology
• Neuroimmunology

Background:

• Progressive Multifocal Leukoencephalopathy (PML) is a demyelinating disease of the central nervous system, predominantly affecting the white matter.
• Deep grey matter involvement in PML is rare and often secondary to adjacent white matter lesions.
• The basal ganglia are the most commonly affected deep grey matter structures, typically showing secondary involvement.

Observation:

• This report details a biopsy-proven case of PML with an atypical presentation.
• The observed PML lesions were predominantly located within the thalamus, a deep grey matter structure.
• This contrasts with the typical white matter predilection and secondary basal ganglia involvement seen in PML.

Findings:

• The case demonstrated primary thalamic lesions in PML, challenging the conventional understanding of its anatomical distribution.
• Histopathological confirmation via biopsy established the diagnosis of PML.
• The findings suggest that PML can manifest with primary deep grey matter involvement, specifically in the thalamus.

Implications:

• This case expands the spectrum of radiological and pathological findings in PML.
• It underscores the importance of considering PML in the differential diagnosis of thalamic lesions, even in the absence of typical white matter involvement.
• Further research may be warranted to explore the mechanisms underlying primary deep grey matter PML and its clinical significance.