McKeith et al reported the process for counting Lewy bodies in brain histology at the 1996 consensus conference for dementia with Lewy bodies (DLB).
Sections examined:
(1) brainstem
(2) anterior cingulate (limbic): rostral to the anterior commissure, about 1.5 cm caudal to the anterior pole of the genu
(3) transentorhinal (limbic): sulcal margin (collateral sulcus) of the parahippocampal gyrus in the plane of the red nucleus
(4) frontal (neocortical): middle frontal gyrus in the superior frontal sulcus at the plane just rostral to the temporal tip
(5) temporal (neocortical): superior sulcal margin (superior temporal sulcus) of the middle temporal gyrus at the plane of the amygdaloid and mammillary body
(6) parietal (neocortical): superior sulcal margin (intraparietal sulcus) of the parietal lobe at the plane 1 cm caudal to the posterior pole of the splenium
The tissue blocks should be taken perpendicularly, avoiding tangential cuts.
Staining: immunostaining with antibodies to ubiquitin with or without immunostaining with anti-tau (to exclude globose neurofibrillary tangles)
Number of Lewy Bodies per Section |
Points |
0 |
0 |
1 to 5 |
1 |
6 or more |
2 |
total nonbrainstem score =
= SUM(points for sections 2 to 6)
Categories:
(1) brainstem predominant
(2) limbic (transitional)
(3) neocortical (diffuse)
Count |
Brainstem Predominant |
Limbic |
Neocortical |
cingulate |
0 or 1 |
1 to 2 |
2 |
transentorhinal |
0 or 1 |
1 to 2 |
2 |
frontal |
0 |
0 or 1 |
1 to 2 |
temporal |
0 |
1 |
1 to 2 |
parietal |
0 |
0 |
1 to 2 |
total nonbrainstem |
0 to 2 |
3 to 6 |
7 to 10 |
Specialty: Neurology
ICD-10: ,