Abstract
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunocompromised patients. To date, PML with discrete involvement of the pyramidal tract has been described in only two patients. This report describes an additional case with PML showing discrete involvement of the pyramidal tract on T2-weighted images and FLAIR images.
Highlights
Progressive multifocal leukoencephalopathy (PML), a disease of the central nervous system (CNS), is characterized by destructive infection of oligodendrocytes by JC virus [1]
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunocompromised patients
This report describes an additional case with PML showing discrete involvement of the pyramidal tract on T2-weighted images and FLAIR images
Summary
Progressive multifocal leukoencephalopathy (PML), a disease of the central nervous system (CNS), is characterized by destructive infection of oligodendrocytes by JC virus [1]. The characteristic MRI appearance of PML is single or multifocal lesions that are round to oval at first and which become confluent and large with progression of the disease. The involvement of arcuate fibres creates a sharp border with the cortex. The lesions are hypointense on T1-weighted images and are hyperintense on T2weighted and FLAIR images. Lesions do not enhance and have no mass effect [2]. Characteristic MR appearances have been reported in PML, dilemmas of differentiation from other diseases can occur based on imaging alone. This report describes a case presenting unusual MR features of discrete involvement of the pyramidal tract in light of the literature
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