J Korean Med Sci.  2022 Jun;37(23):e195. 10.3346/jkms.2022.37.e195.

One Autopsy Proved Neocortical Lewy Body Disease Without the Involvement of the Olfactory Bulb and Brainstem

• Chung EJ
• Cho HJ
• Hur DY
• Kim YS
• Lee KH
• Kim SJ

• KMID: 2530483
• DOI: http://doi.org/10.3346/jkms.2022.37.e195

Abstract

Lewy bodies (LBs) and Lewy neurites (LNs) are pathological hallmarks of Parkinson’s disease (PD) or dementia with LBs (DLB). Incidental Lewy body disease (iLBD) is defined when LBs and LNs are found in the brain of normal elderly individuals. A 65-year-old man presented with autopsy-proven Lewy body pathology (LBP). He had never complained of cognitive impairments or parkinsonian motor symptoms, and he had always maintained independence in activities of daily living. Hypopigmentations in the locus coeruleus and substantia nigra were discovered during the autopsy. The patient showed severe-to-extremely severe LBs in the neocortex and limbic areas, except in the nucleus basalis of Meynert, amygdala, and brainstem, according to microscopic findings. Hence, using several of the previously known staging systems, it was difficult to classify the patient’s LBP type. Furthermore, these findings were unique because they had never been observed before in iLBD.

Keyword

Incidental Lewy Body Disease; Parkinson Disease; Lewy Body Dementia; Lewy Bodies; Lewy Neurites; Synucleinopathies