Department of Neurology and Neurological Science, Tokyo Medical and Dental University, Japan.
Department of Anatomic Pathology, Tokyo Medical University, Japan.
Intern Med. 2021 Apr 15;60(8):1279-1282. doi: 10.2169/internalmedicine.6040-20. Epub 2020 Nov 9.
A 70-year-old woman with a human T-cell leukemia virus type 1 infection without any focal neurological symptoms showed age-related atherosclerotic changes in the white matter without any suspicious signal changes suggestive of progressive multifocal leukoencephalopathy (PML) based on the findings of MRI. Viral polymerase chain reaction (PCR) revealed 6,700 copies/mL of the JC virus genome in the cerebrospinal fluid (CSF). An immuno-pathological examination of the autopsied brain revealed JC virus capsid proteins, and in situ hybridization confirmed a JC virus infection, indicating that an active infection begins at the radiologically indistinguishable phase of PML. An early JC virus infection is probably associated with small, scattered demyelinating lesions around the cortico-medullary area of the cortex.
一位 70 岁的女性，感染人类 T 细胞白血病病毒 1 ，没有任何局灶性神经症状，磁共振成像显示其大脑白质存在与年龄相关的动脉粥样硬化改变，没有任何提示进行性多灶性白质脑病（PML）的可疑信号变化。病毒聚合酶链反应（PCR）显示脑脊液中 JC 病毒基因组为 6700 拷贝/ml。尸检大脑的免疫病理学检查显示 JC 病毒衣壳蛋白，原位杂交证实了 JC 病毒感染，表明活跃感染始于 PML 影像学无法区分的阶段。早期 JC 病毒感染可能与皮质-皮质下区域周围小而分散的脱髓鞘病变有关。
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