Figure 8. .

Mild perivascular chronic inflammatory cell cuffing in postmortem patient brain. Scattered perivascular lymphocytes (arrows) cuff the blood vessels in the brain stem of patient 1. a, Hematoxylin and eosin stain (640× magnification) and the neocortical white matter. b, LCA immunohistochemistry stain (640× magnification). This inflammatory cell infiltrate is also accompanied by some hemosiderin-laden macrophages, seen only in the deep white matter of the centrum semiovale and the brain stem but not in gray matter or leptomeninges where the acute damage was most severe. Neither of these findings appears to be related to the child’s acute demise; rather, they appear to be chronic. These changes are reminiscent of, though not as severe as, those reported in X-linked adrenoleukodystrophy (MIM 300100).