Table of Contents
Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 2 LBD - Gross Pathology - Cerebrum LBD -Dementia | 10B Case 10 Denouement
Final Neuropathologic Diagnoses: Diffuse Lewy body disease (brainstem, limbic & neocortical); Alzheimer's disease neuropathologic change (A2, B1, C0) ---- Examination of this case reveals evidence of diffuse Lewy body disease and early Alzheimer disease (AD) changes. Supporting a diagnosis of AD, beta-amyloid plaques, but no neuritic plaques, and only sparse neurofibrillary tangles are present in distributions and densities consistent with Braak and Braak neurofibrillary tangle stage I (range: 0-VI) and amyloid stage C (range: 0-C). These findings support a neuropathological diagnosis of Alzheimer disease (AD) by Khachaturian criteria, but the absence of neuritic plaques excludes a diagnosis by CERAD and the NIA-Reagan Institute criteria. In the more recent NIA-AA staging system, this case has AD neuropathologic changes: A2, B1, C0. Supporting a diagnosis of diffuse Lewy body disease, this case displays alpha-synuclein positive inclusions in the forms of Lewy bodies and Lewy neurites in the brain stem, limbic and neocortical areas. The density and distribution of these lesions are sufficient to meet the neuropathologic criteria for LBD dementia.
