Multiple-System Atrophy in Long-Term Professional Painter: A Case Report

Figure 2

(A–H) Histological and immunohistochemical findings. Interfascicular oligodendroglia with halos in the cytoplasm and astrocytes are observed along with nerve fibers (A, HE staining). α-synuclein staining reveals numerous α-synuclein-positive glial cytoplasmic inclusions (GCI) in the oligodendroglia in the cerebral cortex (B). In the midbrain, the oligodendroglia and astrocytes show severe cytogenic edema (C, HE staining). α-synuclein-positive GCI in the oligodendroglia is also seen in the midbrain (D). The medulla oblongata shows extensive neuronal loss with scant oligodendroglial cells (E, HE staining), where α-synuclein is positive in the cytoplasma (F). Neuronal loss and gliosis are observed in the spinal cord (G, HE staining). Some α-synuclein-positive GCI in the oligodendroglia and astrocytes (arrows) are seen in the spinal cord (H).