case_images: PMC10782519_01
case_images: Gross specimen revealing marked cortical atrophy with spongiform appearance of white matter predominantly (scale bar = 5 cm).
case_images: autopsy-13-e2023465-g01.jpg
case_images: PMC10782519_01_autopsy-13-e2023465-g01.jpg
case_images: gf01
case_images: Multiple cystic cavities were present predominantly in the white matter (Figure 1).
case_images: Photomicrographs of the central nervous system. A - demonstrates spongiform/vacuolar degeneration of the white matter in a background of reactive gliosis and infarct necrotic areas (H&E, 100x); B - shows numerous axonal spheroids, and macrophages infiltration in the degenerated cystic parenchyma (H&E, 400x); C - Luxol-Fast Blue (LFB) stain revealing rarefaction of myelinated nerve fibers (200x); D - CD68 IHC stain highlighting the macrophages (400x).
case_images: autopsy-13-e2023465-g02.jpg
case_images: PMC10782519_01_autopsy-13-e2023465-g02.jpg
case_images: gf02
case_images: The microscopic evaluation revealed extensive spongiform or vacuolar degeneration in the form of pseudocyst formation of the deep white matter, axonal swelling, and axonal loss (Figure 2A). Blood vessels were normal, and there was no evidence of any inflammatory or infective process (Figure 2B). Myelin stain revealed diffuse demyelination and axonal loss (Figure 2C). CD 68 immunohistochemistry (IHC) highlighted the infiltration of macrophages in the parenchyma (Figure 2D).