Alzheimer’s neuropathology | Figure 1

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Alzheimer’s neuropathology

Elderly man with clinically suspected Alzheimer’s disease. Autopsy performed after several years of progressive short term memory loss and word finding difficulties.

Images 1 & 2: Bielschowsky silver stain showing prominent senile plaques and “flame-shaped” neurofibrillary tangles, respectively. Hyperphosphorylated tau is intensely argyrophilic (silver stains darkly). Immunostaining, which is becoming more common, ubiquitin or P62.

Image 3: H&E shows basophilic granules within non-staining vacuoles (granulovacuolar degeneration).

These processes can be seen in normal aging and are not specific to Alzheimer’s, but their density and location correlates strongly with symptom severity.

Image 4: H&E in hippocampus CA1 region. Pyramidal cell with a Hirano Body (eosinophilic rod) and granulovacuolar degeneration. This is more specific to this region and AD. Subtly basophilic neurofibrillary tangle can also be seen in the cytoplasm of the Neuron below.