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Figure 2 | Journal of Medical Case Reports

Figure 2

From: Subacute herpes simplex virus type 1 encephalitis as an initial presentation of chronic lymphocytic leukemia and multiple sclerosis: a case report

Figure 2

Left occipital brain biopsy performed on 15 March 2009. A) Hematoxylin and eosin (H&E) stain (100×) showing a sharp border between relatively normal neuropil inferiorly and a paler area of gliosis representing a lack of myelin superiorly. B) H&E stain (200×) showing a peri-vascular cuff consisting of lymphocytes and histiocytes. C) H&E stain (400×) showing an inflammatory infiltrate rich with histiocytes. D) Immunoperoxidase stain (200×) for CD68 macrophages showing strong positivity in areas of gliosis. The final pathological diagnosis was gliosis and reactive changes consistent with demyelinating disease. The findings were negative for lymphoma. An immunostain for herpes simplex virus (HSV) was also negative. Other immunohistochemistry stains were as follows: B cell marker CD20 was positive in a few B cells, T cell marker CD3 was positive for several T cells, B cell marker CD79 was positive in a few B cells, and proliferation marker Ki-67 was low at 3%.

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