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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 4 LBD - Gross Pathology - LBD-Dementia with AD | 3C Case 3 Denouement
Not shown: Multiple H&E sections of frontal, parietal, temporal and occipital neocortices showed large numbers of senile plaques and neurofibrillary tangles, highlighted by multiple methods including Bielschowsky silver stains, PHF1 and 10D5 for BAP. Also present in cortical neurons of frontal and cingulate cortices are many intracytoplasmic Lewy bodies which are aSYN immunoreactive. Simultaneous immunolocalization of PHF-1 and a-synuclein occasionally show coexistence of Lewy bodies and neurofibrillary tangles within the same neurons. Sections of the midbrain show neuron loss and astrocytosis with scattered Lewy bodies and neurofibrillary tangles by a-synuclein and PHF1 immunostains. ---- Neuro Final Diagnosis: Alzheimer's disease; Diffuse cortical Lewy body disease; Infarct, resolving/chronic, left parietotemporal lobe ---- Neuro Diagnosis Comment: The main neuropathologic findings in the autopsy of this patient include a large number of diffuse and neuritic senile plaques highlighted by amyloid immunohistochemistry, neurofibrillary tangles and Lewy bodies in neocortices, hippocampus, substantia nigra and locus ceruleus. Coexistence of Alzheimer's disease and Parkinson's disease/cortical Lewy body disease has been previously shown and may be found in as high as 35% of cases of Alzheimer's disease.
