Document 0416
 DOCN  M9440416
 TI    Simultaneous progressive multifocal leukoencephalopathy, Epstein-Barr
       virus (EBV) latent infection and cerebral parenchymal infiltration
       during chronic lymphocytic leukemia.
 DT    9404
 AU    Farge D; Herve R; Mikol J; Sauvaget F; Ingrand D; Singer B; Ferchal F;
       Auperin I; Gray F; Sudaka A; et al; Department of Internal Medicine,
       Saint Louis Hospital, Paris VII; University, France.
 SO    Leukemia. 1994 Feb;8(2):318-21. Unique Identifier : AIDSLINE
       MED/94142327
 AB    We report a non-HIV patient who had B chronic lymphocytic leukemia (CLL)
       with progressive multifocal leukoencephalopathy (PML) and diffuse
       cerebral leukemic parenchymal infiltration in the presence of JC virus
       and Epstein-Barr virus (EBV) cerebral co-infection. Multiple subcortical
       hypodensities lining the cortico-subcortical junction were present
       within the white matter on computerized tomography (CT) scan, with large
       areas of high signal intensity on T2-weighted sequences on magnetic
       resonance imaging (MRI). JCV DNA was identified in peripheral blood
       nuclear cells and cerebrospinal fluid polymerase chain reaction (PCR)
       DNA/DNA hybridization plus Southern blot analysis. Frontal stereotactic
       biopsy confirmed the diagnosis of PML by immunocytochemistry, in situ
       hybridization (ISH) with JC Enzo probe and electron microscopy. Leukemic
       B cells with the same phenotype as leukemic blood cells were
       disseminated in the demyelinated areas. They were labeled by anti-latent
       membrane protein and by BamHl W EBV probe after ISH. Adhesion and
       activation molecules were positive for CD23. Autopsy showed diffuse
       visceral leukemic infiltration without acutization. EBV-transformed B
       lymphocytes would favour JCV penetration and/or intracerebral
       reactivation of previously latent JCV infection with further development
       of simultaneous PML and cerebral CLL infiltration in an immunosuppressed
       patient.
 DE    B-Lymphocytes/MICROBIOLOGY  Brain/*PATHOLOGY  Case Report  Cell
       Transformation, Viral  Herpesviridae
       Infections/*COMPLICATIONS/MICROBIOLOGY  *Herpesvirus 4, Human/PHYSIOLOGY
       Human  Leukemia, B-Cell, Chronic/*COMPLICATIONS/PATHOLOGY  *Leukemic
       Infiltration  Leukoencephalopathy, Progressive Multifocal/*COMPLICATIONS
       Lymphocyte Transformation  Male  Middle Age  Papovaviridae
       Infections/COMPLICATIONS  Polyomavirus hominis 2  Tumor Virus
       Infections/*COMPLICATIONS/MICROBIOLOGY  *Virus Latency  JOURNAL ARTICLE

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