65 year-old female with alzheimer’s disease

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.

2

An autopsy was performed. Identify the structures arrow.

3

Hippocampus

Thalamus

Corpus callosumCaudate, tail

Lateral geniculate nucleus

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

4

Normal Severe atrophy

library.med.utah.edu

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

5

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

• Neuritic plaques • Neurofibrillary tangles• Amyloid plaques

6

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

• Neuritic plaques • Neurofibrillary tangles• Amyloid plaques

7

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

8

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

9

• Hirano bodies

Where in the hippocampus can you find these bodies?

10

Where in the hippocampus can you find these bodies?

11

• CA1 region of the hippocampus

CA4

CA1

CA2CA3

Dentate gyrus

What are the 4 most common genes linked to AD?

12

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