FINE-NEEDLE ASPIRATION BIOPSY OF PROGRESSIVE MULTIFOCAL LEUKOENCEPHALOPATHY IN A PATIENT WITH AIDS - A CASE-REPORT

BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is one of the most common opportunistic infections, with a range of 4-7% in acq uired immuno-deficiency syndrome (AIDS) patients. Clinical diagnosis i s often difficult, and the specific pathologic agent requires cytologi c and pathologic confirmation. CASE: A 38-year-old, Haitian male was a dmitted with a new-onset seizure disorder. On computed tomography (CT) , there were right frontoparietal cortex, right external capsule and r ight basal ganglia lucencies. Fine needle aspiration biopsy (FNAB) of the radiolucent area revealed foci of white matter demyelination and a fete eosinophilic inclusions in oligodendrocytes plus abnormal giant astrocytes. Ultrastructurally, JC virions were observed in the nuclei and cytoplasm of the oligodendrocytes. CONCLUSION: Diagnostic cranial CT-guided FNAB, with cytologic and histologic studies, is extremely va luable in evaluating the nature of central nervous system demyelinated and space-occupying lesions in AIDS.