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Washington University Experience | NEURODEGENERATION | Multiple Systems Atrophy (MSA) | 12C3 MSA (Case 12) N7 pSYN 7.jpg
pSyn IHC shows numerous GCI and some neuronal cytoplasmic inclusions (NCI) within the basis pontis. ---- Not shown: H&E stained sections of the left basal ganglia and cortex have pSYN GCI these are moderate within the internal capsule, moderate-to-frequent within the external capsule and claustrum, rare in the caudate, and sparse in the basal forebrain. H&E stained sections of the midbrain show generally moderate and focally severe neuronal loss from the substantia nigra; the very caudal portion of the substantia nigra shows severe gliosis and neuronal loss laterally. Frequent GCIs are seen in the white matter throughout the medulla, including the pyramids. Atrophy of the inferior olives, with regionally variable mild-to-moderate neuronal losses are described. pSyn IHC reveals multiple NCI within the inferior olivary nuclei, ---- Neuro Final Diagnosis: Multiple system atrophy (Gilman et al. PMID: 10223419, MSA, striatonigral degeneration-type / parkinsonism-type (MSA-P).
