Figure 3. Brain imaging and neuropathologic studies in patient PT-5 diagnosed with progressive multifocal leukoencephalopathy Brain imaging and neuropathologic.

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Presentation transcript:

Figure 3. Brain imaging and neuropathologic studies in patient PT-5 diagnosed with progressive multifocal leukoencephalopathy Brain imaging and neuropathologic studies in patient PT-5 diagnosed with progressive multifocal leukoencephalopathy (A) MRI in patient PT-5 shows an extensive area of signal abnormalities in both T2-weighted and fluid-attenuated inversion recovery (FLAIR) MRI sequences that involved the white matter of the left posterior region of the frontal-parietal lobes. (B) Histologic changes observed in hematoxylin & eosin stain demonstrated extensive gliosis, presence of gemystocytic astrocytes, and mild inflammatory reaction. (C) Next-generation sequencing (NGS) analysis reveals 8,944 JC polyomavirus reads out of 8,954 reads from all viruses. The whole genome of JC polyomavirus was covered by the reads, at an average depth over 200. The NGS findings are consistent with a diagnosis of progressive multifocal leukoencephalopathy (PML). (D) Immunostaining with SV-40 antibodies, a surrogate for JC virus identification, shows several immunopositive nuclei as confirmation of JC virus infection. These findings confirm the diagnosis of PML. Steven L. Salzberg et al. Neurol Neuroimmunol Neuroinflamm 2016;3:e251 © 2016 American Academy of Neurology