Document Detail

Diagnosis of progressive multifocal leukoencephalopathy by stereotactic brain biopsy utilizing immunohistochemistry and the polymerase chain reaction.
MedLine Citation:
PMID:  7847007     Owner:  NLM     Status:  MEDLINE    
This report describes the diagnosis of progressive multifocal leukoencephalopathy (PML) in nine patients using cytopathologic and histopathologic examination of computed tomographically guided stereotactic brain biopsies in combination with immunostaining for SV-40-related antigen and the polymerase chain reaction (PCR) for the JC virus. In four patients the diagnosis of PML was based on the microscopic appearance of the biopsies and immunostaining for SV-40-related antigen. In one of these patients the diagnosis was also supported by PCR for the JC virus. In two patients whose biopsies were only suggestive of PML, a definitive diagnosis was possible utilizing immunohistochemistry and PCR. In another case the histopathologic features were atypical of PML, and the diagnosis was established with immunostaining and PCR. The diagnosis of PML was established by PCR alone in two patients whose biopsies showed only suggestive or nonspecific findings. We conclude that the accuracy of stereotactic biopsy in the diagnosis of PML is enhanced by using a combination of light microscopy, immunohistochemistry and PCR.
S A Silver; R R Arthur; Y S Erozan; M E Sherman; J C McArthur; S Uematsu
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Acta cytologica     Volume:  39     ISSN:  0001-5547     ISO Abbreviation:  Acta Cytol.     Publication Date:    1995 Jan-Feb
Date Detail:
Created Date:  1995-03-06     Completed Date:  1995-03-06     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370307     Medline TA:  Acta Cytol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  35-44     Citation Subset:  IM; X    
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland.
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MeSH Terms
Antigens, Polyomavirus Transforming / analysis
Base Sequence
Biopsy / methods
Brain / pathology*,  radiography
DNA, Viral / analysis,  genetics
Genome, Viral
HIV Infections / complications
JC Virus / genetics
Leukoencephalopathy, Progressive Multifocal / complications,  diagnosis*,  pathology*
Magnetic Resonance Imaging
Middle Aged
Molecular Sequence Data
Oligonucleotide Probes / analysis,  chemistry,  genetics
Polymerase Chain Reaction
Tomography, X-Ray Computed
Grant Support
Reg. No./Substance:
0/Antigens, Polyomavirus Transforming; 0/DNA, Viral; 0/Oligonucleotide Probes

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