GiaRusso M H, Koeppen A H
J Neurol Sci. 1978 Feb;35(2-3):391-8. doi: 10.1016/0022-510x(78)90019-9.
Atypical progressive multifocal leukoencephalopathy occurred in an 82-year-old man with long-standing chronic lymphocytic leukemia. The multifocal white matter lesions revealed demyelination and gliosis, relative preservation of axons and a prominent plasma cell infiltrate. Bizarre astrocytes were uncommon. There were no changes in the oligodendroglial nuclei and no inclusion bodies. Electron and immunohistofluorescence microscopy for papova virus were negative. In addition to this leukoencephalopathy a small primary cerebral lymphoma was present in the right occipital lobe. The tumor cells were plasmacytoid in appearance and their cytoplasm stained well with pyronin. They contained IgG by immunohistofluorescence microscopy. The neoplasm was considered an immunoblastic sarcoma (reticulum cell sarcoma) and thought to arise directly within foci of demyelination. Both disease processes, leukoencephalopathy and lymphoma, may have occurred on a background of immunosuppression.
一名患有长期慢性淋巴细胞白血病的82岁男性发生了非典型进行性多灶性白质脑病。多灶性白质病变显示脱髓鞘和胶质增生，轴突相对保留，并有显著的浆细胞浸润。奇异星形胶质细胞并不常见。少突胶质细胞核无变化，也无包涵体。针对乳头多瘤空泡病毒的电子显微镜和免疫荧光显微镜检查均为阴性。除了这种白质脑病外，右枕叶还存在一个小的原发性脑淋巴瘤。肿瘤细胞外观呈浆细胞样，其细胞质用派洛宁染色良好。免疫荧光显微镜检查显示它们含有IgG。该肿瘤被认为是免疫母细胞肉瘤（网状细胞肉瘤），并被认为直接起源于脱髓鞘灶内。白质脑病和淋巴瘤这两种疾病过程可能都发生在免疫抑制的背景下。
