The identification of cells containing JC papovavirus DNA in progressive multifocal leukoencephalopathy by combined in situ hybridization and immunocytochemistry

A double‐labelling technique combining in situ hybridization and immunocytochemistry is described which was used to characterize cells in the central nervous system containing JC virus DNA in formalin‐fixed, paraffin‐embedded tissues from four cases of progressive multifocal leukoencephalopathy. All four cases showed positive nuclear labelling for JC virus in both oligodendrocytes and astrocytes. The latter gave a strongly positive cytoplasmic staining reaction using antibodies to glial fibrillary acidic protein and vimentin. No nuclear labelling of neurones or endothelial cells was noted. The results confirm previous suggestions that glia are the main cells infected by JC virus in this disorder and show that the distribution of viral DNA in the brain is more extensive than suggested by routine microscopy alone. In situ hybridization for JC virus may be useful in confirming the diagnosis of progressive multifocal leukoencephalopathy in both surgical biopsies and post‐mortem brain tissue.