Mitchell M A, Nakamura S M, Godyn J J, Schwarz K O
Department of Pathology, Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019.
Arch Pathol Lab Med. 1990 May;114(5):485-7.
In an article published in 1985, Hedley-Whyte described "pink spots," which she observed in gross sections of human brains fixed in formaldehyde solution. Hedley-White found that the spots in question were associated with the presence of bacteria within central nervous system blood vessels. We have recently encountered three cases of Hedley-Whyte-type pink spots during routine postmortem brain examination. In two of these cases, the patient's clinical history included a bacterial infection, which could account for the deposition of bacteria within the central nervous system blood vessels. In the third case, the patient had no clinical history of bacterial infection, and had a negative postmortem blood culture. On microscopic examination, all three cases showed central nervous system intravascular presence of bacteria within the macroscopically recognized pink spots. To test the hypothesis that pink spots result from bacterial fermentation products, at the time of postmortem removal of brains (different from the brains mentioned above), we perfused blood vessels in three brains with 100% ethanol. Subsequent macroscopic examination after fixation in formaldehyde revealed discoloration similar to the Hedley-Whyte spots.
