Baló concentric sclerosis

Case contributed by Austin Neuropathology
Diagnosis certain

Presentation

Right-sided neurological symptoms.

Patient Data

Age: 30 years
Gender: Male
mri
This study is a stack
Axial
T2
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
This study is a stack
Axial
T1
This study is a stack
Axial
FLAIR
This study is a stack
Axial
T1 C+
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Info

MRI demonstrates a focal periventricular lesion with high T2, low T1 and no significant enhancement.

pathology
H&E
Neurofilament
ab
Luxol
Fast Blue
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Info

Neurofilament antibody demonstrating axonal sparing and Luxol Fast Blue showing almost complete demyelination, with myelin debris in macrophages.

Case Discussion

Although not as prominent as in some cases, there is the appearance of a number of concentric alternating high and low bands on T2 weighted imaging, which raises the possibility of Baló concentric sclerosis, a variant of MS

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