Leptomeningeal Lymphoid-Like Structure Found in Early Multiple Sclerosis

Leptomeningeal lymphoid-like structures (LLS) were previously noted to be prevalent in progressive multiple sclerosis (MS), correlating with disease severity (NEJM JW Neurol Nov 2011 and Brain 2011; 134:2755). Imaging studies suggested the presence of LLS in early MS, little pathologic material has been available. Investigators have now studied autopsy material from 12 patients with acute MS, with median disease duration 2 y (range, 0.3–4 years) and median age at death 35 years (range, 22–58). Also studied were autopsy samples from 3 patients with primary progressive MS and 18 with secondary progressive MS.

The percent of cortical gray matter with demyelination was 11.9% in acute MS and 29.1% in progressive MS. The percent of white matter de…