MM2-cortical-type sporadic Creutzfeldt-Jakob disease with early stage cerebral cortical pathology presenting with a rapidly progressive clinical course
Article first published online: 10 APR 2008
© 2008 Japanese Society of Neuropathology
Volume 28, Issue 6, pages 645–651, December 2008
How to Cite
Niimi, Y., Iwasaki, Y., Umemura, T., Tanaka, F., Yoshida, M., Hashizume, Y., Kitamoto, T., Hirayama, M. and Sobue, G. (2008), MM2-cortical-type sporadic Creutzfeldt-Jakob disease with early stage cerebral cortical pathology presenting with a rapidly progressive clinical course. Neuropathology, 28: 645–651. doi: 10.1111/j.1440-1789.2008.00904.x
- Issue published online: 23 OCT 2008
- Article first published online: 10 APR 2008
- Received 31 July 2007; revised 17 December 2007; accepted 20 January 2008.
- irregular plaque-like prion protein deposition;
- large confluent vacuole-type spongiform change;
- perivacuolar-type prion protein deposition;
- sporadic Creutzfeldt-Jakob disease
We report the case of a 67-year-old man with MM2-cortical-type sporadic Creutzfeldt-Jakob disease (sCJD) with a rapidly progressive clinical course of 5 months. Initial symptoms were progressive memory disturbance and dementia. MRI revealed high signal-intensity lesions on diffusion-weighted images in the bilateral frontal and occipital cortices. Myoclonus and periodic sharp-wave complexes on the electroencephalogram were observed in the early disease stage. The clinical diagnosis was typical sCJD. Neuropathologic examination at autopsy showed widespread, characteristic cerebral neocortical involvement with large confluent vacuole-type spongiform change. Spongiform degeneration was also evident in the striatum and medial thalamus. In the cerebellar cortex, slight depletion of Purkinje neurons was evident without spongiform change in the molecular layer or apparent neuron loss in the granule cell layer. The inferior olivary nucleus showed slight hypertrophic astrocytosis without neuron loss. Prion protein (PrP) immunostaining showed widespread, characteristic perivacuolar-type PrP deposits with irregular plaque-like PrP deposits in the cerebral neocortex, striatum and medial thalamus. We believe this patient showed early-stage cerebral cortical pathology of MM2-cortical-type sCJD, which may provide clues regarding the pathologic progression of this rare sCJD subtype. Although MM2-cortical-type sCJD generally shows slow progression without myoclonus or periodic sharp-wave complexes, the present patient showed a rapidly progressive clinical course similar to that of MM1-type sCJD.