Meningovascular Syphilis

Meningovascular syphilis manifests 5 to 7 years after the initial infection and presents with meningeal and multifocal cerebral and/or spinal cord symptoms and signs.

The pathology is characterized by a proliferative endarteritis of the small, medium, and large arteries (Heubner endarteritis). A prominent endothelial proliferation along with mononuclear cell infiltrates in the media and adventitia lead to severe luminal narrowing and, eventually, occlusion and subsequent infarctions (Fig. 6.25).

Neurosifilis Meningovascular

FIGURE 6.22

Cerebral and visceral aspergillosis. A 51-year-old man underwent nephrectomy for carcinoma that had already spread to the vertebrae and pelvis. Postoperatively, he received radiation, chemotherapy, and corticosteroids. Three years following surgery, he developed an acute pneumonitis that did not improve on broad-spectrum antibiotics. Three weeks later, he died. An unen-hanced CT scan of the head shows two hypodense lesions: (A) one in the left frontal lobe and (B) the other with a hyperdense component in the right central region. C. Horizontal slice of the brain shows poorly defined hemorrhagic necrotic lesions in the left frontal and right central regions. D. Aspergillus hyphae fill the lumen and penetrate the wall of a small leptomeningeal artery (Grocott stain). E. Cerebral cortex showing freely dispersed aspergillus hyphae and necrotic blood vessel (PAS) and (F) hemorrhages and microabscesses (HE). Colonies of aspergillus hyphae in (G) the lung (Grocott stain) and (H) heart (HE).

FIGURE 6.22

Cerebral and visceral aspergillosis. A 51-year-old man underwent nephrectomy for carcinoma that had already spread to the vertebrae and pelvis. Postoperatively, he received radiation, chemotherapy, and corticosteroids. Three years following surgery, he developed an acute pneumonitis that did not improve on broad-spectrum antibiotics. Three weeks later, he died. An unen-hanced CT scan of the head shows two hypodense lesions: (A) one in the left frontal lobe and (B) the other with a hyperdense component in the right central region. C. Horizontal slice of the brain shows poorly defined hemorrhagic necrotic lesions in the left frontal and right central regions. D. Aspergillus hyphae fill the lumen and penetrate the wall of a small leptomeningeal artery (Grocott stain). E. Cerebral cortex showing freely dispersed aspergillus hyphae and necrotic blood vessel (PAS) and (F) hemorrhages and microabscesses (HE). Colonies of aspergillus hyphae in (G) the lung (Grocott stain) and (H) heart (HE).

0 0

Post a comment