PMC4329689_01
MRI brain and histopathology images. (A) T2 axial image shows multiple small T2-isointense lesions (arrows) with perilesional edema (B) Diffusion-weighted image (DWI) shows restricted diffusion of the lesions (arrow) (C) Post-contrast axial image shows enhancing lesions in the subependymal (double arrows) and gray-white junction (arrowhead) distribution. Also note the brainstem and cervical cord lesions in the post-contrast sagittal (D) image (arrows) (E and F) Photomicrographs illustrating lymphohistiocytic infiltrate in an angiocentric pattern (H and E,x90)
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F1
M 4, V4), generalized rigidity, and sphincter incontinence. MRI (Siemens 1.5 Tesla Avanto Germany 2005) of brain [Figure 1A-D] showed multiple small enhancing nodules in subependymal and ependymal regions, along the vessels, and gray-white junction. Histopathology [Figure 1E and F] from right temporal lobe biopsy showed cerebral gray and white matter with reactive astrocytosis, densely infiltrated by sheets of small and medium-sized CD3+ T cells with coarse clumped chromatin and scant cytoplasm.
MRI brain images at 3 months follow-up (A) T2 axial image shows decrease in the number of T2-isointense lesions and perilesional edema (arrow) (B) DWI does not show any restriction (C and D) Post-contrast images show fewer enhancing nodular lesions in the subependymal regions and deep gray nuclei (arrows)
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F2
His repeat MRI brain showed atrophy, with reduction in the number and size of the enhancing nodular lesions and perilesional edema [Figure 2].