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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 4 LBD - Gross Pathology - LBD-Dementia with AD | 11B Case 11 Denouement
Routine and Bielschowsky stained sections of the frontal, occipital, and mesial temporal lobes show abundant (>>15 neuritic plaques per 20x field) amyloid cored and neuritic plaques, scattered neurofibrillary tangles and dystrophic neurites. Thioflavin S stained sections show abundant leptomeningeal and cortical vessels containing amyloid as well as abundant amyloid plaques. Multiple cortical Lewy bodies are present in neurons of the deep cortical layers of the temporal and occipital lobes and the orbital surface of the frontal lobe. Sections of midbrain show moderate to marked loss of pigmented neurons in the substantia nigra, most prominently involving its lateral aspect and in the locus ceruleus. Within the remaining pigmented neurons, multiple Lewy bodies and scattered pale bodies are noted. ---- Neuro Final Diagnosis: Diffuse Lewy body disease (dementia with Lewy bodies [DLB]); Alzheimer's disease; Cerebral amyloid angiopathy
