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. 2021 Jun 14;56(11):773–784. doi: 10.1097/RLI.0000000000000804

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Pathologic hallmarks of multiple sclerosis (MS). Multiple sclerosis is defined by focal inflammatory and demyelinating white matter lesions (A), frequently forming around a centrally located vein (B). Multiple sclerosis pathology also affects gray matter including the cortical ribbon; cortical lesions have been phenotypically classified into (1) leukocortical lesions, (2) intracortical lesions, (3) subpial lesions, and (4) cortex-spanning lesions (C). Multiple sclerosis pathology also affects the leptomeningeal compartment, as defined by cellular infiltrates and/or lymphoid follicles (D). The inflammatory front of chronic active white matter lesions can show iron-laden phagocytes (E).