Progressive multifocal leukoencephalopathy: a burnt-out case.
Progressive multifocal leukoencephalopathy: a burnt-out case.
复制标题
进行性多灶性白质脑病：一个精疲力竭的病例。
DOI：
10.1002/ana.410130503
复制
发表时间：
1983
影响因子：
11.2
通讯作者：
Walker,D
中科院分区：
文献类型：
--
作者：
Price,RW;Nielsen,S;Horten,B;Rubino,M;Padgett,B;Walker,D
何杰金氏病患者发展为进行性多灶性脑白质病（PML），经脑活检证实与JC病毒感染有关。他的病情发展了几个月，导致严重的神经功能障碍，但随后稳定下来，在他生命的剩余一年里几乎没有进一步的临床进展。尸检时对大脑的组织病理学评估支持临床印象，即大脑感染已被阻止。脑活检显示活动性PML的组织学特征，包括巨大奇异的星形胶质细胞，而死后检查的脑病变表现为不活跃，星形胶质细胞变化消退，少突胶质包涵体消除。同样，在脑活检中发现的JC病毒抗原在尸检脑中未被检测到。本病例提供了进一步的证据，证明PML并不总是致命的，临床和细胞学上的缓解是可以发生的。
A patient with Hodgkin's disease developed progressive multifocal leukoencephalopathy (PML), documented by brain biopsy to be associated with JC virus infection. His disease progressed over several months, resulting in severe neurological deficit, but then stabilized with little or no further clinical progression during the remaining year of his life. Histopathological evaluation of the brain at autopsy supported the clinical impression that brain infection was arrested. Whereas the brain biopsy exhibited the histological features of active PML including giant bizarre astrocytes, at postmortem examination brain lesions appeared inactive, with regression of astrocytic changes and elimination of oligodendroglial inclusions. Similarly, JC virus antigen, present in the brain biopsy, was not detected in the autopsied brain. This case provides further evidence that PML is not invariably fatal and that clinical and cytological remission can occur.