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Basic Neuropathology 7

Topic: Imaging

Created on Thursday, February 14 2013 by gliageek

Last modified on Thursday, February 14 2013.

This hippocampal section was taken from the brain of a patient who presented with a 6 month history of progressive cognitive decline. The best diagnosis is?

 
        A) Limbic encephalitis
 
        B) Herpes simplex encephalitis
 
        C) Human immunodeficiency virus associated dementia
 
        D) Frontotemporal lobar degeneration
 
        E) Jakob-Creutzfeldt disease
 

 


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This question was created on February 14, 2013 by gliageek.
This question was last modified on February 14, 2013.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANSWERS AND EXPLANATIONS




A) Limbic encephalitis

This answer is correct.


The presence of microglia nodules with brisk reactive astrocytosis without liquefactive necrosis characterizes limbic encephalitis. this is characteristically, but not invariably, associated with underlying malignancy (specifically, small cell carcinoma of the lung).   (See References)

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B) Herpes simplex encephalitis

This answer is incorrect.


Herpes simplex encephalitis is characterized by severe necrosis in addition to the findings seen within this slide.   (See References)

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C) Human immunodeficiency virus associated dementia

This answer is incorrect.


Although microglial nodules are seen within HAD, they're located predominantly within the white matter and basal ganglia, and usually demonstrate the presence of multi-nucleated microglial cells resulting from viral induced fusion.   (See References)

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D) Frontotemporal lobar degeneration

This answer is incorrect.


Frontotemporal lobar degeneration is a noninflammatory degenerative condition, and does not show microglia nodules.   (See References)

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E) Jakob-Creutzfeldt disease

This answer is incorrect.


Prion diseases, such as Jakob-Creutzfeldt disease, are characterized by the absence of an inflammatory infiltrate, as the pathogenic protein is a confirmational variant of a normal cellular protein, and is hence not recognized as foreign body immune system.   (See References)

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References:

1. (2012). "The diagnosis and treatment of limbic encephalitis." , 126(6) 365-75. (PMID:22713136)
2. Kayser, M.S., Kohler, C.G., and Dalmau, J. (2010). "Psychiatric manifestations of paraneoplastic disorders." Am J Psychiatry, 167(9) 1039-50. (PMID:20439389)
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imaging
Basic Neuropathology 7
Question ID: 021413084
Question written by gliageek. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 02/14/2013
Modified: 02/14/2013
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