Details
Disease Category
Gender
Age
69 years
Organ System/Discipline
Diagnosis
Progressive multifocal leukoencephalopathy
Clinical History
69-year-old woman with past medical history of chronic lymphocytic leukemia treated with chemotherapy. Presents with 2-week history of dysarthria, dysphagia, and ataxia. Neuroimaging shows multiple white matter lesions.
Case Discussion
Progressive multifocal leukoencephalopathy is a CNS demyelinating disorder caused by lytic infection of oligodendrocytes by JC (polyoma) virus. This is almost always due to reactivation of latent virus in an immunocompromised host. Microscopically, there is loss of myelin staining on Luxol Fast Blue along with myelin-laden macrophages and reactive, sometimes bizarre, astrocytes. Oligodendroglial viral inclusions, which can be highlighted with SV40 immunohistochemistry, are also seen. Prognosis is generally poor.
Image Contributors
Gao, A., Munoz, D.
Cite
Gao, A., Munoz, D. Brain, Progressive multifocal leukoencephalopathy. Digital Laboratory Medicine Library, Dept of Laboratory Medicine & Pathobiology, University of Toronto. Published
. Accessed December 17, 2025. https://dev.dlml.cflabs.ca/image/brain-progressive-multifocal-leukoencephalopathy-lmp62751