Progressive multifocal leukoencephalopathy (PML)
Progressive multifocal leukoencephalopathy (PML) is characterized by widespread demyelinative lesions due to infection of oligodendrocytes by a human papovavirus,JC virus.
It occurs almost exclusively in immunosuppressed individuals, such as patients with AIDS, leukemia, or tumors or those undergoing organ transplants. PML is associated with both HIV-1 and HIV-2.
Pathology – Demyelination
IMAGING
Single or multiple confluent lesions without mass effects are seen most frequently in the parietooccipital white matter.
CT - Hypodense lesions
MRI – T1 Hypointense and T2 Hyperintense
Occasional infratentorial lesions are usually asymmetrical.
Rare contrast enhancement with inflammatory PML-during immune recovery following highly active antiretroviral therapy (HAART) initiation
Progressive multifocal leukoencephalopathy (PML) is characterized by widespread demyelinative lesions due to infection of oligodendrocytes by a human papovavirus,JC virus.
It occurs almost exclusively in immunosuppressed individuals, such as patients with AIDS, leukemia, or tumors or those undergoing organ transplants. PML is associated with both HIV-1 and HIV-2.
Pathology – Demyelination
IMAGING
Single or multiple confluent lesions without mass effects are seen most frequently in the parietooccipital white matter.
CT - Hypodense lesions
MRI – T1 Hypointense and T2 Hyperintense
Occasional infratentorial lesions are usually asymmetrical.
Rare contrast enhancement with inflammatory PML-during immune recovery following highly active antiretroviral therapy (HAART) initiation