65 year-old female with Alzheimer’s disease

Lananh Nguyen, M.D.Division of Neuropathology

University of Pittsburgh Medical Center

An autopsy was performed. Identify the structures arrow.

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An autopsy was performed. Identify the structures arrow.

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Hippocampus

Thalamus

Corpus callosumCaudate, tail

Lateral geniculate nucleus

Note the atrophy in the brain with the Alzheimer’s disease.

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Normal Severe atrophy

library.med.utah.edu

What microscopic pathology is in abundance in Alzheimer’s disease (AD)?

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What microscopic pathology is in abundance in Alzheimer’s disease (AD)?

• Neuritic plaques • Neurofibrillary tangles• Amyloid plaques

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What stains would you use to evaluate microscopic pathology in Alzheimer’s disease (AD) for these features?

• Neuritic plaques • Neurofibrillary tangles• Amyloid plaques

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What stains would you use to evaluate microscopic pathology in Alzheimer’s disease (AD) for these features?

• Neuritic plaques : Bielchowsky stain• Neurofibrillary tangles: Phosphorylated tau stain• Amyloid plaques: Beta amyloid stain

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What “body” would you expect to see in the hippocampus of a person with AD

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• Hirano bodies

Where in the hippocampus can you find these bodies?

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Where in the hippocampus can you find these bodies?

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• CA1 region of the hippocampus

CA4

CA1

CA2CA3

Dentate gyrus

What are the 4 most common genes linked to AD?

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• Amyloid precursor protein mutation (causative gene)• Presenilin 1 and Presenilin 2 mutations (causative gene)• Apolipoprotein E4 (risk gene)