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Washington University Experience | NEURODEGENERATION | Argyrophilic Grain Disease (AGD) | 5C0 Case 5 Denouement
Not shown: Both the amygdala and entorhinal cortex show modest neuronal loss and gliosis. Several tau-immunoreactive pre-tangles and tangles and a few neuritic plaques are seen in the amygdala. There are several beta-amyloid plaques in the entorhinal cortex but they are more numerous in the amygdala. No Lewy bodies, Pick bodies, or pTDP-43-immunoreactive NCIs are seen. ---- Neuro Final Diagnosis: Alzheimer disease, mild
Argyrophilic grain disease (stage 1); Atherosclerosis (moderate) with remote infarct in the right occipital lobe ---- Neuro Diagnosis Comment: Examination of this case identifies Alzheimer disease (AD), argyrophilic grain disease (AGD), and vasculopathy (principally, atherosclerosis) with a remote infarct. The brain shows diffuse beta-amyloid plaques, neuritic plaques and neurofibrillary tangles in distributions and densities consistent with Thal beta-amyloid stage C (range: 0, A-C), Braak neurofibrillary tangle stage III (range: 0-VI) and sparse neuritic plaques. These criteria in the NIA-AA staging system is classified as: A2, B2, C1 indicating that there is a ‘moderate’ probability that the AD neuropathologic changes explain the observed cognitive changes. In addition to the features of AD, this brain shows grains, pre-tangles and coiled bodies variably accompanying the neurofibrillary tangles in the amygdala and adjacent medial temporal lobe consistent with AGD. It also shows limited tau-positive ‘ballooned’ neurons in the amygdala.
