PMC9309334_01
Brain magnetic resonance imaging (MRI) performed at the 1-month, 3-month, and 12-month follow-ups showed T1-weighted, diffusion-weighted images (DWI), fluid-attenuated inversion recovery (FLAIR) and enhanced T1 MRI axial images of the centrum semiovale, brachium pontis and internal capsule lesions.
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F1
Brain magnetic resonance imaging (MRI) (Figure 1) demonstrated symmetric abnormalities on fluid-attenuated inversion recovery (FLAIR) hyperintensity within the white matter of the corona radiata, brachium pontis, and basal ganglia, with T1-weighted associated hypointensity (T1WI), without enhancing lesions but with correlating areas of hyperintensity on DWI. Repeated MRI showed a stable lesion without new changes after 3 months (Figure 1). Repeat brain MRI at 1 year showed minimal residual hyperintensity on DWI and a small resolution of T2/FLAIR abnormalities, such as in the brachium pontis (Figure 1).
(A) Histopathology showed mild hydropic degeneration and gliocyte proliferation of the lesion (H & E, 400x); (B) GFAP (left panel) and Olig2 (right panel) immunohistochemistry showed positive staining of reactive gliocytes (200x); (C) SYN (left panel) and NF (right panel) immunohistochemistry showed positive staining of neurofilaments. (D) Lymphocytes highlighted by CD3 showed a perivascular infiltration pattern.
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F2
The pathology showed hydropic degeneration, gliocyte proliferation, and perivascular lymphocyte infiltration in the white matter (Figure 2).