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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. Corpus callosum Caudate, tail Thalamus Lateral geniculate nucleus Hippocampus 3 Note the atrophy in the brain with the Alzheimer’s disease. Normal 4 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 • Hirano bodies 9 Where in the hippocampus can you find these bodies? 10 Where in the hippocampus can you find these bodies? • CA1 region of the hippocampus CA3 CA2 CA4 CA1 Dentate gyrus 11 What are the 4 most common genes linked to AD? • Amyloid precursor protein mutation (causative gene) • Presenilin 1 and Presenilin 2 mutations (causative gene) • Apolipoprotein E4 (risk gene) 12