Primary necrosis of corpus callosum with dystrophic astrogliosis and Rosenthal-like fiber formation. The first Chinese case of Marchiafava-Bignami's disease (MBD).

The first Chinese case of MBD is reported as an incidental finding in a non-alcoholic who died from syphilitic heart disease complicated by subacute endocarditis. The extensive necrotic and demyelinating lesion of the body of corpus callosum presents no sandwich appearance. The core of the corpus callosum shows dystrophic astrogliosis with Rosenthal-like fibers and Alzheimer astrocytes, while only reactive astrogliosis is observed in its subpia and subependyma. The development of dystrophic astrogliosis in which gemistocytosis is believed to be the central theme, with the presence of Rosenthal-like fibers and Alzheimer astrocytes in this case denotes possibly a severe metabolic derangement of the affected astroglia. The presence of the subpial and subependymal reactive astrogliosis of the body of corpus callosum to the dystrophic astrogliosis of its core suggests that the same injury may lead to different responses in different subtypes of astrocytes of the same anatomic locus.