Progressive Multifocal Leukoencephalopathy (PML) in the Acquired Immunodeficiency Syndrome (AIDS). A Neuropathological Autopsy Study of 21 Cases

Pathol Res Pract. 1993 Mar;189(2):163-73. doi: 10.1016/S0344-0338(11)80087-7.


In a neuropathological autopsy study of 21 cases of AIDS-associated PML no fundamental morphological differences to non-AIDS PML were found. PML in AIDS often showed very large foci as well as necrotizing lesions. Partial involvement of cerebral cortex and deep gray matter were common findings; infratentorial lesions could be observed in more than three quarters of cases. Perivascular mononuclear infiltrates within PML foci were frequent and obviously not associated with a more benign clinical course. Possible reasons for these peculiarities of PML in AIDS are discussed. In 7 cases evidence of concomitant HIV encephalopathy was found; this may be one relevant factor contributing to severity of PML in AIDS. PML has to be regarded as a common complication of HIV infection, which may show atypical morphological and neuroradiological features.

MeSH terms

  • AIDS-Related Opportunistic Infections / pathology*
  • Adult
  • Autopsy
  • Brain / pathology
  • Female
  • Humans
  • Leukoencephalopathy, Progressive Multifocal / pathology*
  • Male
  • Middle Aged
  • Retrospective Studies