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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 4 LBD - Gross Pathology - LBD-Dementia with AD | 7B Case 7 Denouement
Neuro Microscopic Description: Multiple sections of frontal, parietal, temporal and occipital neocortices show neuronal loss and gliosis. There are frequent diffuse and neuritic plaques and neurofibrillary tangles in the H&E and Bielschowsky stained material from the frontal and hippocampal sections. The number of neuritic plaques does meet the CERAD and Khachaturian criteria for the diagnosis of Alzheimer’s disease. There are numerous cortical Lewy bodies in the cingulate gyrus and the entorhinal cortex. Sections of the midbrain show severe loss of neurons of the substantia nigra and locus ceruleus with astrocytosis with scattered Lewy bodies. ---- Final Neuropathologic Diagnoses: Diffuse Lewy body disease; Alzheimer's disease; Arteriolosclerosis (small vessel disease); Lacunar infarct, remote, left basal ganglia ---- Neuro Diagnosis Comment: The major findings in this case are the presence of Lewy bodies in the substantia nigra, locus ceruleus and limbic cortex, consistent with the diagnosis of diffuse Lewy body disease. Additionally, there were sufficient number of plaques and tangles for a diagnosis of Alzheimer's disease and both of these findings correlate with the clinical history of progressive dementia. (This is an old case before NIA-Reagan or NIA-AA criteria)
