Reverse 'Hot Cross Bun' Sign in Primary Progressive Aphasia- An Atypical MRI Feature

Primary progressive aphasia (PPA) is thought to be a disorder of focal cortical degeneration which occurs as a result of lobar atrophy of dominant frontal and temporal lobe. We report a case of a 78 year old male patient presenting with progressive language affection predominantly and clinically diagnosed as PPA but magnetic resonance imaging (MRI) brain showed an unusual finding of reverse 'hot cross bun' sign in pons in T2 weighted (T2W) / diffusion weighted image (DWI)/ T2 fluid attenuated inversion recovery (FLAIR) axial views. This is the first case report of reverse 'hot cross bun' sign in a case of PPAto the best of our knowledge.