Figure 5.

Hippocampal sclerosis and TAR DNA-binding protein 43 kDa (TDP-43) with diffuse Lewy body disease (Parkinson disease dementia) (Example 3). Patient in the eighth decade of life with symptoms of Lewy body disease and a concomitant clinical diagnosis of Alzheimer disease. As in examples 1, 2, and 5, there is marked neuronal loss in sector CA1 on hematoxylin-eosin (H&E) staining (A), and as in example 2, TDP-43 immunostaining shows innumerable small neurites (B). TDP-43 pathology is also present within small neurons of ventromedial basal forebrain (black arrows) in the area of ventral striatum (C). In addition, conspicuous Lewy body pathology is present in H&E sections within dorsal nucleus of X in the medulla (D) and in cholinergic, magnocellular neurons of basal forebrain (E) (black arrows in [D and E] indicate Lewy bodies). Lewy bodies were conspicuous in H&E-stained sections of temporal cortex, and a single ×400 field stained with α-synuclein identified multiple cortical Lewy bodies and neurites (F) (H&E, original magnification ×400 [A, D, and E]; TDP-43, original magnification ×400 [B and C]; α-synuclein, original magnification × 400 [F]).