Table of Contents
Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 2 LBD - Gross Pathology - Cerebrum LBD -Dementia | 13B Case 13 Denoument
Final Neuropathologic Diagnoses: Diffuse Lewy body disease (Parkinson's disease/dementia with Lewy bodies, limbic); Alzheimer’s disease neuropathologic changes ---- Comment: In the revised criteria, which take into account the co-existence of Lewy body pathology and Alzheimer’s disease pathology, there is a 'high' probability that the cognitive impairment is caused by Lewy body pathology (McKeith et al, PMID: 16237129). Generally few beta-amyloid plaques and isolated patches of more numerous plaques were seen in the neocortex. No neurofibrillary tangles or neuritic plaques were seen in neocortical areas but some were present in low numbers in the medial temporal lobe in distributions and densities consistent with Braak and Braak neurofibrillary tangle stage I (and amyloid stage A (range: A-C). These findings are sufficient for the neuropathological diagnosis of AD according to Khachaturian criteria, but the absence of neuritic plaques excludes AD by CERAD, and the NIA-Reagan Institute criteria. In the more recent NIA-AA criteria, this case has AD neuropathological change consistent with low likelihood of AD (A2, B0, C0).
