Neuroimaging: progressive multifocal leukoencephalopathy: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: progressive multifocal leukoencephalopathy

Sample item

A patient with AIDS has progressive hemiparesis and visual loss. MRI shows asymmetric T2-hyperintense lesions in the parieto-occipital subcortical white matter involving the U-fibres, without mass effect or enhancement. What is the likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Progressive multifocal leukoencephalopathy

PML is demyelination from JC virus reactivation in immunosuppression, including AIDS and natalizumab therapy. It shows asymmetric, non-enhancing subcortical lesions that extend into the arcuate fibres, without mass effect.

Option by option

  • A. HIV encephalopathy

    HIV encephalopathy shows diffuse symmetrical periventricular change with cerebral atrophy.

  • B. Primary CNS lymphoma

    Lymphoma is an enhancing mass with oedema.

  • C. Progressive multifocal leukoencephalopathy (correct)

    Correct. Asymmetric subcortical white matter disease without mass effect or enhancement is typical.

  • D. Cerebral toxoplasmosis

    Toxoplasmosis forms ring-enhancing lesions with oedema in the basal ganglia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Radiology questions

Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is C, Progressive multifocal leukoencephalopathy. PML is demyelination from JC virus reactivation in immunosuppression, including AIDS and natalizumab therapy.

Why is "HIV encephalopathy" not the answer?

HIV encephalopathy shows diffuse symmetrical periventricular change with cerebral atrophy.

Why is "Primary CNS lymphoma" not the answer?

Lymphoma is an enhancing mass with oedema.

Why is "Cerebral toxoplasmosis" not the answer?

Toxoplasmosis forms ring-enhancing lesions with oedema in the basal ganglia.

What concept does this question test?

It tests Neuroimaging: progressive multifocal leukoencephalopathy in Radiology. It shows asymmetric, non-enhancing subcortical lesions that extend into the arcuate fibres, without mass effect.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: progressive multifocal leukoencephalopathy?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.