Multidrug chemotherapeutic regiments administered for the treatment of malignant gliomas and metastatic malignancies, in addition to affecting the bone m arrow, may produce a coagulative necrotizing leukoencephalopathy.

figure. 1 1.47

Late delayed radiation leukoencephalopathy in a 64-year-old man. Following a resection of a primary lymphoma, he received first a total dose of 5,000 rads and, 2 years later, a total does of 3,800 rads. Macrosection from the cerebral hemisphere shows cavitated white matter, areas of coagulative necrosis, and preservation of the cortex (HE).

The degeneration of myelin is accompanied by a loss of oligodendrocytes and extensive axonal changes.

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