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Washington University Experience | MYELIN (NON-IMMUNE MEDIATED) | Necrotizing Leukoencephalopathy | 3A1 DNL (MTX & Rx Mantle Cell Lymphoma, Case 3) 1
3A1,2 The weight of the unfixed brain was 1250 gm. This coronal section shows little gross pathology. Microscopically the cerebral hemispheres and underlying white matter showed only scattered lymphocytic infiltrate but no evidence of mantle cell lymphoma or DNL. In this case, the thalamus showed patchy lesions characterized by neuron loss, parenchymal necrosis, eosinophilic neurons, vacuolation, axonal spheroids, foamy macrophages, microcalcifications, and perivascular cuffing of small, mature lymphocytes were identified, a pattern similar to but not identical to the changes in the pons where neurons are preserved and there are few perivascular lymphocytes.
