IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 1(4):369-375;2008

Original Article
Limbic Lobe Microvacuolation is Minimal in Alzheimer’s Disease in the Absence of
Concurrent Lewy Body Disease

Yasuhiro Fujino and Dennis W. Dickson

Neuropathology Laboratory, Department of Pathology, Mayo Clinic College of Medicine, Jacksonville, FL, USA

Received 6 Sept 2007; accepted and available online 1 January 2008

Abstract: Microvacuolation is relatively common in the limbic lobe in Lewy body disease (LBD). Similar pathology has also been reported in
Alzheimer's disease (AD). Almost all of the studies of microvacuolation in AD, however, antedated the routine application of sensitive
immunohistochemical methods to detect Lewy bodies. This raises the possibility that microvacuolation previously reported in AD may have
been due to unrecognized LB pathology. To explore this issue, α-synuclein immunohistochemistry was used to evaluate a consecutive series
of AD as well as cases with mixed AD and LBD (AD/LBD). Independently, the degree of microvacuolation was graded in the entorhinal cortex
and the amygdala of the same cases. The results showed that microvacuolation was more common and more severe in AD/LBD than in pure
AD cases. In pure AD cases microvacuolation was related to senile plaque density, especially in the amygdala, where many of the neuropil
vacuoles were around dense-cored, neuritic plaques. In contrast, in AD/LBD microvacuolation correlated with LB density in the entorhinal cortex
and amygdala. These results suggest that microvacuolation has a different pathogenesis in AD and in AD/LBD. Moreover, when prominent
microvacuolation is detected in AD, it is imperative to exclude concurrent LBD. (IJCEP709002).

Key Words: Alzheimer's disease, Lewy body disease, microvacuolation, spongiosis

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Address all correspondence to: Dennis W. Dickson, MD, Neuropathology Laboratory, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL
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