The Diagnostic Slide Session at the recent American Association of Neuropathologists annual meeting in Philadelphia featured a fascinating case by Dr. Sandra Camelo-Piragua, Ronald A. Goerss, and David N. Louis of Massachusetts General Hospital. The case was that of a 38-year-old AIDS patient who had been only intermittently compliant with his HAART therapy. He presented to the hospital with seizures in 2009 after a year of fluctuating neurological symptoms. Imaging studies showed the following white matter changes:
Immunohistochemistry of one of the lymphoid follicles indicated that the lymphoid infiltrate was a reactive, rather a neoplastic process:
Polyoma virus immunohistochemistry for the SV40 (a surrogate marker for JC virus due to cross-reactivity) was found to be positive:
University of Michigan!