A case of progressive multifocal leukoencephalopathy with methionine uptake demonstrated by PET

Hirofumi Ochi, Takeshi Yamada, Hideo Hara, Takeo Yoshimura, Toru Iwaki, Kazuo Nagashima, Yoshiaki Yogo, Takuro Kobayashi

研究成果: ジャーナルへの寄稿学術誌査読

6 被引用数 (Scopus)


We report here a 55-year-old man with progressive multifocal leukoencephalopathy (PML) associated with chronic adult T cell leukemia (ATL). Neurological examination revealed mild dementia, right homonymous hemianopsia and visual agnosia. Serologically anti-HTLV-1 antibody was positive. Peripheral blood analysis showed ATL cells up to 23% in white blood cells. Because he did not have symptoms or signs directly related to ATL, it was considered that he had chronic ATL. T2-weighted cranial MRI demonstrated multiple hyperintensity lesions confined to the white matter from the bilateral occipital to parietal lobes, without enhancement after gadolinium administration or mass effect. We performed stereotactic biopsy of the left occipitoparietal white matter. Histological examination of the biopsied specimens showed demyelinated lesions, containing foamy macrophages and bizarre astrocytes. Oligodendrocytes contained nuclear inclusions which reacted with an antibody against the JC virus (JCV) antigen. These findings were consistent with those of PML. The genomic analysis of JCV from the biopsied brain revealed deletions in the regulatory region. We invesigated cerebral blood flow, glucose and amino acid metabolism in this patient using position emission tomography, and obtained the following three characteristic findings in the lessions: 1) luxury perfusion state, 2) decreased fluorodeoxyglucose (FDG) uptake, and 3) increased methionine (Met) uptake. These findings resembled those of low grade tumors.

ジャーナルClinical Neurology
出版ステータス出版済み - 7月 1996

!!!All Science Journal Classification (ASJC) codes

  • 臨床神経学


「A case of progressive multifocal leukoencephalopathy with methionine uptake demonstrated by PET」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。