Table of Contents
Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 6 LBD - Microscopic Pathology - Cerebral Cortex | 8C Case 1 Denouement
Neuro Final Diagnosis: Alzheimer's disease; Dementia with Lewy bodies ---- Neuro Diagnosis Comment: Histological slides of representative neocortical areas show sparse to focally frequent beta-amyloid plaques, few to focally frequent neuritic plaques and neurofibrillary tangles, consistent with tangle stage V of a six-stage scale (range: IVI) in the Braak and Braak staging system (PMID: 12498954) of tangles and amyloid stage C (range: A-C). These findings are sufficient to meet the neuropathological criteria for the diagnosis of Alzheimer's disease according to the criteria of Khachaturian, CERAD and the NIA-Reagan Institute. In addition to tauopathy and beta-amyloid pathology, this case also displayed alpha-synuclein-positive inclusions in the form of Lewy bodies and Lewy neurites. In the staging of Lewy body pathology according to Braak et al. this case is consistent with stage 6 of a six stage scale (range: 1-6). The density and distribution of these lesions is sufficient to meet the criteria for dementia with Lewy bodies (PMID: 12498954), neocortical stage, and in the revised criteria, which take account of coexisting LBD-Dementia and Alzheimer's disease, there is an “intermediate” probability that the dementia is caused by Lewy body disease. McKeith et al. criteria (PMID: 16237129).
