An autopsy case of progressive multifocal leukoencephalopathy with massive iron deposition in juxtacortical lesions.
ferritin
hemosiderin-phagocytic macrophage
reactive astrocyte
susceptibility-weighted image
visual disturbance
Journal
Neuropathology : official journal of the Japanese Society of Neuropathology
ISSN: 1440-1789
Titre abrégé: Neuropathology
Pays: Australia
ID NLM: 9606526
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
06
02
2023
received:
18
11
2022
accepted:
06
02
2023
medline:
23
10
2023
pubmed:
28
2
2023
entrez:
27
2
2023
Statut:
ppublish
Résumé
Progressive multifocal leukoencephalopathy (PML) is a severe demyelinating disease caused by JC virus infection of oligodendrocytes. Little has been reported on iron deposits in patients with PML. Herein, we report a case of PML with massive iron deposition in the juxtacortical regions attaching white matter lesions in a 71-year-old woman who developed bilateral visual disturbance and progressive aphasia after 16 months of rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone treatment for follicular lymphoma. Magnetic resonance imaging revealed white matter lesions in the left parietal and other lobes with massive iron deposition in the juxtacortical lesions. A PCR test for JC virus was positive, confirming the diagnosis of PML. Despite treatment with mefloquine and mirtazapine, the patient died six months later. At autopsy, demyelination was found dominantly in the left parietal lobe. Moreover, hemosiderin-laden macrophages and reactive astrocytes containing ferritin were abundant in the juxtacortical regions adjacent to the white matter lesions. This is a previously unreported case of PML after lymphoma, in which iron deposition was confirmed both radiologically and pathologically.
Substances chimiques
Rituximab
4F4X42SYQ6
Cyclophosphamide
8N3DW7272P
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
396-402Subventions
Organisme : Research Committee of Prion Disease and Slow Virus Infection, Research on Policy Planning and Evaluation for Rare and Intractable Diseases, Health and Labour Sciences Research Grants, the Ministry of Health, Labour and Welfare, Japan, KAKENHI
ID : 22H04923
Organisme : Research Committee of Prion Disease and Slow Virus Infection, Research on Policy Planning and Evaluation for Rare and Intractable Diseases, Health and Labour Sciences Research Grants, the Ministry of Health, Labour and Welfare, Japan, KAKENHI
ID : 18K06506
Organisme : Research Committee of Prion Disease and Slow Virus Infection, Research on Policy Planning and Evaluation for Rare and Intractable Diseases, Health and Labour Sciences Research Grants, the Ministry of Health, Labour and Welfare, Japan, KAKENHI
ID : 21K06417
Organisme : Research Committee of Prion Disease and Slow Virus Infection, Research on Policy Planning and Evaluation for Rare and Intractable Diseases, Health and Labour Sciences Research Grants, the Ministry of Health, Labour and Welfare, Japan, KAKENHI
ID : 21K07450
Organisme : AMED
ID : 22dk0307115h0001
Organisme : AMED
ID : JP21wm0425019
Organisme : National Center of Neurology and Psychiatry
ID : intramural fund
Informations de copyright
© 2023 Japanese Society of Neuropathology.
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