DEMYELINATING DISEASE Flashcards
WHAT CONDITION
A. Perivascular lymphocytic infi ltration (HE).
B. Disintegration of myelin into oilred- O–positive neutral lipid globules.
C. Macrophages remove myelin debris (HE).
D. Fibrous astrocytes produce fi ne fi brillary processes (Holzer stain)
ACUTE MS
WHAT CONDITION?
(A) Demyelination and (B) dense astrocytic gliosis in a subcortical plaque. C. Extensive Demyelination in the tegmentum and small demyelinated foci in the basis of the pons and D. Dense astrogliosis within demyelinated areas
CHRONIC MS
WHAT STRUCTURES ARE SHOWN?
Nerve fi ber changes within MS plaques. A. At the margin of a plaque, the myelin sheaths are sharply disrupted but a reduced number of nerve fi bers is spared. B. Moderate and (C) total loss of nerve fi bers in the center of a chronic plaque (Holmes
stain).
WHAT STRUCTURE IS SHOWN IN THIS PT WITH MS
Oligodendrocytes within chronic MS plaques.
A. Oligodendrocytes are sparse among large fi brillary astrocytes.
B. Plaque depleted of oligodendrocytes
(HE).
WHAT CONDITION?
A 30-year-old woman presented with a history of headaches and rapidly progressing Loss of vision in the left eye that began about 5 weeks following a diffi cult labor and a short febrile episode. Shortly after the onset of visual impairment, she developed paresthesias and weakness in all four extremities and urinary retention. After a short period of improvement, her condition deteriorated; she became quadriplegic and experienced respiratory diffi culties. Six months after the onset of symptoms, she died. A. Extensive demyelination in left optic nerve. B. Extensive demyelination in the swollen cervical and thoracic cord (Weil stain). C. Massive perivascular lymphocytic infi ltration (HE)
NMO
shows zones of myelin losses alternating
with zones of intact myelin in a circular fashion (myelin
stain).
BALO
Extensive demyelination
in one frontal lobe extends into the corpus callosum
(PTAH).
SCHILDER
WHAT CONDITION
A and B. Spinal cord showing demyelination along radially oriented veins (myelin stain). C. Dense infi ltrations with neutrophils, lymphocytes, and macrophages in the demyelinated zones (cresyl violet).
ADEM
WHAT CONDITION?
A 42-year-old man, with a 3-week history of muscle and stomach aches and cough, suddenly developed headaches, neck pain, fever, and left hemiparesis. Four days later, he became hemiplegic and comatose. Six days after the headaches began, he died. Grossly, the hemispheric white matter displayed multiple petechial hemorrhages. Histologic section shows fi brinoid necrosis of a small vessel, dense perivascular and diffuse parenchymal infi ltrations with neutrophils and lymphocytes, and small
hemorrhages (HE).
Acute hemorrhagic leukoencephalitis
