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Figure 2 Neuropathology of PML lesions in a patient with MS treated with fingolimod Neuropathology of PML lesions in a patient with MS treated with fingolimod.

Published byGerard Allison Modified over 5 years ago

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Presentation on theme: "Figure 2 Neuropathology of PML lesions in a patient with MS treated with fingolimod Neuropathology of PML lesions in a patient with MS treated with fingolimod."— Presentation transcript:

1 Figure 2 Neuropathology of PML lesions in a patient with MS treated with fingolimod
Neuropathology of PML lesions in a patient with MS treated with fingolimod (A) Fragments of biopsied brain tissues (hematoxylin-eosin: HE staining). Affected lesions were obscure with HE staining. A and B are serial sections (scale bar: 500 mm). (B) Although demyelinated lesions were not clear with Kluver-Barrera staining, there were 4 demyelinating areas with high density of CD68+ cells lacking myelin-associated glycoprotein (MAG) or myelin basic protein (MBP). Two of them were relatively in subacute (C–E) and acute phases (F–L). (C) In typical oval demyelinating lesion with massive macrophage infiltration, there was a lesion with dominant loss of MAG compared with partially lacked MBP (D) with CD8-positive cells at the periphery (E), suggesting a subacute demyelinated lesion with distal oligodendrogliopathy. C–E is a serial section (scale bar: 200 μm). (F) In another active inflammatory lesion (HE staining), there were massive infiltrations of macrophages and lymphocytes diffusely in demyelinating lesions. In these lesions, oligodendroglia-like cells with mildly enlarged nuclei were present (green arrows). An astroglia-like cell suspicious for JC virus (JCV) infection was also seen (yellow arrow). Within serial sections of F, loss of MAG was present (G) with completely preservation of MBP (H), suggesting in acute phase. F–H is a serial section (scale bar: 200 μm). (I–L) Properties of inflammatory cells (I: CD3, J: CD8, and K: CD79a). There were numerous CD3+ T cells and CD79a+ B cells and plasma cells, and both helper and cytotoxic T cells were present in an almost equal ratio, where JCV-infected cells were observed (L: in situ hybridization (ISH) VP1). I–L is a serial section (scale bar: 50 μm). PML = progressive multifocal leukoencephalopathy. Shuhei Nishiyama et al. Neurol Neuroimmunol Neuroinflamm 2018;5:e415 Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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