Fascinating Image No. 2

Prepared by GG Kovacs

39-year-old man with a history of progressive cognitive decline and focal neurological symptoms. This raised the suspicion of Creutzfeldt-Jakob disease. Neuropathology examination revealed perivascular histiocytes and macrophages, here immunolabelled with the antibody CD68, throughout the brain. The accumulation of PAS positive cytoplasmic structures raised the suspicion of Whipple’s disease, which was confirmed by further examinations. Whipple's disease is a rare systemic infectious disease caused by the bacterium Tropheryma whipplei. The disorder is mostly affecting the gastrointestinal system but may involve other organs including the central nervous system causing complex and progressive neurological symptoms.