進(jìn)行性多灶性白質(zhì)腦病

圖1 光學(xué)顯微鏡觀察所見 HE 染色 ×400 1a 病灶周邊可見胞核增大、內(nèi)有胞核內(nèi)包涵體的少突膠質(zhì)細(xì)胞1b 病灶內(nèi)可見多形性或多核的星形膠質(zhì)細(xì)胞 圖2 光學(xué)顯微鏡觀察顯示，受感染的少突膠質(zhì)細(xì)胞胞核表達(dá)SV40 免疫組化染色（EnVision 二步法） ×200Figure 1 Optical microscopy findings HE staining ×400 Inclusion?bearing, enlarged nuclei in virally infected oligodendrocytes, sit at the periphery of demyelinated foci(Panel 1a). Nuclear hyperchromasia and pleomorphism of astrocytes were also evident (Panel 1b). Figure 2 Optical microscopy showed SV40 was positive in infected oligodendrocytes. Immunohistochemical staining(EnVision) ×200

進(jìn)行性多灶性白質(zhì)腦病是一種中樞神經(jīng)系統(tǒng)脫髓鞘性疾病，由JC 病毒機會性感染所致。病變常位于灰白質(zhì)交界處，髓鞘染色可見髓鞘脫失，病灶內(nèi)特別是活動性病灶內(nèi)有大量泡沫細(xì)胞，僅可見散在淋巴細(xì)胞浸潤。受感染的少突膠質(zhì)細(xì)胞胞核較大、深染，“毛玻璃”樣改變的少突膠質(zhì)細(xì)胞多見于病灶周邊（圖1a），病灶內(nèi)及周圍腦組織可見體積增大、深染、異形性或多核、胞質(zhì)豐富的星形膠質(zhì)細(xì)胞（圖1b），組織活檢或冰凍病理學(xué)檢查易誤診為腫瘤細(xì)胞。免疫組化染色，受感染的少突膠質(zhì)細(xì)胞胞核表達(dá)JC 和SV40（圖2），高表達(dá)P53 和Ki?67。