PMC3970353_01
Ill-defined FLAIR hyperintense lesion seen in central pons (a) and restricted diffusion noticed in pons on DWI sequence (b).
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fig1
MRI of the spine revealed intramedullary T2 hyperintensity extending from T2 to T10 level (Figures 1 and 2).
(a) Axial T2W of thoracic spinal cord and (b) sagittal T2W of thoracic spinal cord demonstrating intramedullary central T2 hyperintensity which extends from T2 to T10 level. (c) Coronal FLAIR demonstrating hyperintensity along the walls of the lateral and third ventricles, brainstem, and lateral geniculate bodies; on T1 postcontrast imaging (d) mild enhancement is noticed along the walls of the lateral ventricles.
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fig2
MRI of the spine revealed intramedullary T2 hyperintensity extending from T2 to T10 level (Figures 1 and 2).
Coronal section of pons (a) demonstrating area of grey-tan softening enclosed peripherally by tissue of normal appearance; thoracic spinal cord section (b) demonstrating central grey area with granular appearance; coronal section of brain (c) demonstrating symmetrical grey-brown spots above temporal horns; and lateral geniculate body and subependymal area (d) with grey-brown and granular appearance.
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fig3
The lesion in the lateral geniculate bodies and subependymal regions also shared similar morphologic characteristics to the pons (Figures 3 and 4).
H and E staining of pons (a) shows neurons at the base well preserved against background of demyelinated area and LFB staining of pons (b) demonstrating demyelinated triangular shaped area in central portion of basis pontis. H and E staining of spinal cord (c) shows demyelination in central portion of spinal cord and well preserved fascicle on upper right and LFB staining of the cord (d) demonstrating demyelination of spinal cord and macrophages around blood vessels (left of center).
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fig4
The lesion in the lateral geniculate bodies and subependymal regions also shared similar morphologic characteristics to the pons (Figures 3 and 4).