OJMI  Vol.2 No.3 , September 2012
Unusual MR Feature Presenting Discrete Involvement of Pyramidal Tract in Progressive Multifocal Leukoencephalopathy: A Case Report
Abstract: Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease caused by reactivation of JC virus in immunocompromised patients. To date, PML with discrete involvement of the pyramidal tract has been described in only two patients. This report describes an additional case with PML showing discrete involvement of the pyramidal tract on T2-weighted images and FLAIR images.
Cite this paper: M. Umino, M. Maeda, N. Matsushima, A. Itoh, A. Taniguchi and H. Tomimoto, "Unusual MR Feature Presenting Discrete Involvement of Pyramidal Tract in Progressive Multifocal Leukoencephalopathy: A Case Report," Open Journal of Medical Imaging, Vol. 2 No. 3, 2012, pp. 100-102. doi: 10.4236/ojmi.2012.23018.

[1]   J. R. Berger and E. O. Major, “Progressive Multifocal Leukoencephalopathy,” Seminars in Neurology, Vol. 19, No. 2, 1999, pp. 193-200. doi:10.1055/s-2008-1040837

[2]   R. Shah, A. K. Bag, P. R. Chapman and J. K. Curé, “Imaging Manifestations of Progressive Multifocal Leukoencephalopathy,” Clinical Radiology, Vol. 65, No. 6, 2010, pp. 431-439. doi:10.1016/j.crad.2010.03.001

[3]   E. J. Boren, G. S. Cheema, S. M. Naguwa, A. A. Ansari and M. E. Gershwin, “The Emergence of Progressive Multifocal Leukoencephalopathy (PML) in Rheumatic Diseases,” Journal of Autoimmunity, Vol. 30, No. 1-2, 2008, pp. 90-98. doi:10.1016/j.jaut.2007.11.013

[4]   M. Bergui, G. B. Bradac, K. K. Oguz, A. Boghi, C. Geda, G. Gatti, et al., “Progressive Multifocal Leukoencephalopathy: Diffusion-Weighted Imaging and Pathological Correlations,” Neuroradiology, Vol. 46, No. 1, 2004, pp. 22-25. doi:10.1007/s00234-003-1115-9

[5]   A. Iranzo, A. Moreno, J Pujol, J. Martí-Fàbregas, P. Domingo, J. Molet, et al., “Proton Magnetic Resonance Spectroscopy Pattern of Progressive Multifocal Leukoencephalopathy in AIDS,” Journal of Neurology, Neurosurgery & Psychiatry, Vol. 66, No. 4, 1999, pp. 520-523. doi:10.1136/jnnp.66.4.520

[6]   A. Semmler, H. Urbach, T. Klockgether and M. Linnebank, “Progressive Multifocal Leukoencephalopathy with Selective Involvement of the Pyramidal Tracts,” Neurology, Vol. 68, No. 11, 2007, p. 871. doi:10.1212/01.wnl.0000257132.24299.76

[7]   N. Sobha, S. Sinha, A. B. Taly, G. R. Arunodaya, S. Ravishankar, B. Anandh, et al., “Progressive Multifocal Leucoencephalopathy with Discrete Involvement of Pyramidal Tract,” Journal of Neurology, Neurosurgery & Psychiatry, Vol. 76, No. 1, 2005, p. 24. doi:10.1136/jnnp.2004.046003

[8]   K. E. Rollins, B. K. Kleinschmidt-DeMasters, J. R. Corboy, D. M. Damek and C. M. Filley, “Lymphomatosis Cerebri as a Cause of White Matter Dementia,” Human Pathology, Vol. 36, No. 3, 2005, pp. 282-290. doi:10.1016/j.humpath.2005.01.014

[9]   J. Pallud, B. Devaux, C. Daumas-Duport, C. Oppenheim and F. X. Roux, “Glioma Dissemination along the Corticospinal Tract,” Journal of Neuro-Oncology, Vol. 73, No. 3, 2005, pp. 239-240. doi:10.1007/s11060-005-0378-x

[10]   E. Duron, A. Lazareth, J. Y. Gaubert, C. Raso, O. Hanon and A. S. Rigaud, “Gliomatosis Cerebri Presenting as Rapidly Progressive Dementia and Parkinsonism in an Elderly Woman: A Case Report,” Journal of Medical Case Reports, Vol. 20, No. 2, 2008, p. 53. doi:10.1186/1752-1947-2-53

[11]   A. Yu, K. Li and H. Li, “Value of Diagnosis and Differential Diagnosis of MRI and MR Spectroscopy in Gliomatosis Cerebri,” European Journal of Radiology, Vol. 59, No. 2, 2006, pp. 216-221. doi:10.1016/j.ejrad.2006.03.001

[12]   K. Sakushima, M. Yashima-Yamada, K. Kubota, Y. Sawamura, I. Yabe and H. Sasaki, “Gliomatosis Cerebri with Multifocal Progressive Lesions on MRI,” Rinsho shinkeigaku, Vol. 51, No. 2, 2011, pp. 145-148. doi:10.5692/clinicalneurol.51.145

[13]   R. del Carpio-O’Donovan, I. Korah, A. Salazar and D. Melan?on, “Gliomatosis Cerebri,” Radiology, Vol. 198, No. 3, 1996, pp. 831-835.

[14]   S. Terae and A. Ogata, “Nonenhancing Primary Central Nervous System Lymphoma,” Neuroradiology, Vol. 38, No. 1, 1996, pp. 34-37. doi:10.1007/BF00593213

[15]   M. D. Jenkinson, T. S. Smith, A. R. Brodbelt, K. A. Joyce, P. C. Warnke and C. Walker, “Apparent Diffusion Coefficients in Oligodendroglial Tumors Characterized by Genotype,” Journal of Magnetic Resonance Imaging, Vol. 26, No. 6, 2007, pp. 1405-1412. doi:10.1002/jmri.21062