Table of Contents
Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 6 LBD - Microscopic Pathology - Cerebral Cortex | 4C Case 4 Denouement
Neuro Final Diagnoses: Dementia with Lewy bodies; Alzheimer's disease neuropathologic change; Small vessel disease ---- Neuro Diagnosis Comment: The main neuropathological findings of this case are diffuse Lewy body disease (dementia with Lewy bodies) and Alzheimer's disease. Frequent beta-amyloid plaques, rare neuritic plaques and neurofibrillary tangles were present but the CERAD and NIA-Reagan were not met. This case also displayed alpha-synuclein-positive inclusions in the form of Lewy bodies, Lewy neurites, and threads/grains in brain stem, limbic, and neocortical areas. The density and distribution of these lesions is sufficient to meet the criteria for dementia with Lewy bodies (neocortical type) and according to Braak et al. this case is stage 6 (range: 0,1-6) PMID: 12498954); however, the loss of neurons in the substantia nigra and locus coeruleus is only mild-to-moderate. In the revised criteria which take into account presence of both Diffuse Lewy body dementia and Alzheimer’s disease, there is a “high” probability that the dementia is caused by DLB (McKeith et al. (PMID: 16237129).
