Fig. 3.

Cellular inflammation in anti-IgLON5 disease. Cellular inflammation was mild to moderate and mainly composed of perivascular and parenchymal CD3 (a) and CD8 positive T cells (b) and few perivascular CD79a positive B cells/plasma cells (c). Parenchymal CD8 T cells were granzyme B positive and granules showed a polarization towards neurons (d; arrows). In addition, neurons showed an upregulation of MHC class I in the reticular formation and olivary nuclei (e, rectangle enlarged in f). Marked microglia activation was found in the HLA-DR staining in the tegmentum of medulla oblongata and nucleus olivaris (g), including the formation of microglial nodules (h; rectangle in g enlarged in h). Images are depicted from patient 1. Scale bars: 50 μm