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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 2 LBD - Gross Pathology - Cerebrum LBD -Dementia | 9B Case 9 Denouement
Final Neuropathologic diagnoses: Alzheimer disease is excluded according to the criteria of Khachaturian, CERAD, NIA-Reagan, and NIA-AA.; Diffuse Lewy body disease (neocortical stage) with dementia; Subacute infarct in parietal lobe (8 x 6 x 3 cm); Primary age-related tauopathy (neurofibrillary tangles in medial temporal lobe) ---- Comment: The main neuropathological finding in this case is diffuse Lewy body disease, the pathological correlate of LBD – dementia. Other pathologies include cerebral vascular disease with infarcts in the parietal lobe and cerebellum, and primary age-related tauopathy. This case displays alpha-synuclein-positive inclusions in the form of Lewy bodies and Lewy neurites in brainstem, limbic and neocortical areas. The density and distribution of these lesions are sufficient to meet the criteria for the diagnoses of LBD dementia and given the distribution of Lewy bodies this is consistent with a neocortical stage. There is age-related medial temporal lobe tauopathy (PART). However, the tauopathy is very mild and unlikely to have made a significant contribution to the cognitive deficits. As there are no beta-amyloid plaques, Alzheimer disease is excluded according to the criteria of Khachaturian, CERAD, NIA-Reagan, and the NIA-AA.
