1. “SOME BODIES IN THE BRAIN” Noon Diagnostic Conference 11-20-2003
Ronald L. Hamilton, M.D.
Associate Professor of Neuropathology,
University of Pittsburgh

2. Some Bodies in the Brain
Identify these “bodies” that populate neuropathology

3. Psammoma bodies

4. Verocay body

5. Eosinophilic Granular Bodies (EGB)

6. Negri bodies

7. Cortical Lewy Body

8. Round basophilic inclusion #1
(Pick body vs. mnd inclusion body)

9. Round basophilic inclusion #2
(Pick body vs. mnd inclusion body)

10. Bunina bodies

11. Corpora amylacea

12. PAS stain
Lafora body (polyglucosan body)

13. Hirano body

14. Granulovacuolar degeneration (Simchowicz bodies)

15. Marinesco body

16. Herring bodies

17. Buscaino bodies (mucocytes)

19. Zebra bodies

21. Fingerprint bodies

22. Psammoma bodies
Psammoma bodies:
meningioma

23. Psammoma bodies Derived from meningothelial whorls
Psammomatous meningioma
spinal cord (females)

24. Psammoma bodies melanotic Schwannomas - 50% are psammomatous
half of melanotic psammomatous Schwannomas have Carney complex
Auto dominant
mutation in Protein kinase A holoenzyme
lentiginous facial pigmentation
cardiac myxoma, calcifying Sertoli cell tumors
endocrine overactivity
Cushing syndrome
multinodular adrenal hyperplasia
acromegaly - pituitary adenoma

25. Verocay bodies Schwannoma Antoni A areas
Infrequent in acuostic and cellular Schwannomas

26. Verocay bodies Bilateral acoustic schwannomas = NF II
autosomal dominant 22q12 - merlin (schwannomin)
similar to cytoskeletal proteins moesin, ezrin, radixin (MER)
+meningiomas, spinal ependymomas, posterior lens opacities, meningioangiomatosis

27. Eosinophilic Granular Bodies (EGB)
Gangliogliomas, Pilocytic Astrocytomas, Pleomorphic Xanthoastrocytoma
Degenerating tumor astrocytes
PAS-positive

28. Eosinophilic Granular Bodies (EGB)

29. Eosinophilic Granular Bodies (EGB)

30. Negri bodies Rabies encephalitis Purkinje cells, CA-1 hippocampus
>10,000 human deaths per year

31. Negri bodies

32. Lewy bodies
Parkinson’s Disease
DLB, LBVAD, MSA, age

33. Lewy bodies
May be multiple

34. Lewy bodies Cortical Lewy bodies
Entorhinal cortex, cingulate gyrus, insular cortex, other neocortex

35. Lewy bodies Cortical LB can be difficult to detect on H&E
Strongly ubiquitin-positive (vs. globose NFT)

36. Lewy bodies
Alpha-synuclein positive, specific and sensitive

37. Lewy bodies Hyaline bodies are abnormal aggregates of AS
May be precursor to LB

38. Pick bodies Pick’s disease Fronto-temporal dementia
Severe neuronal loss and gliosis (“knife-edge” atrophy)
Neocortex, dentate gyrus

39. Pick bodies
Tau
Strongly argyrophilic (silver stains - Bielschowsky, Bodian)
++tau, +ubiquitin
+/- Pick cells (balloon cells)
EM-straight filaments
Pick cell

40. MND-inclusion bodies Motor Neuron Disease (MND) inclusion body
ALS, ALS with dementia or aphasia
FTD (mnd-inclusion body dementia),
Primary progressive aphasia
Superficial neocortex, dentate gyrus
NOT IN MOTOR NEURONS

41. MND-inclusion bodies ubiquitin ubiquitin Negative silver stain
Ubiquitin positive
Negative for tau and alpha-synucelin
Composition unknown

42. Pick bodies vs. mnd-inclusion bodies
Tau I
MND-inclusion
ubiquitin
Bielschowsky

43. Bunina bodies
Lower motor neurons
ALS
Unknown composition

44. ALS - other LMN inclusions
Hyaline bodies
Ubiquitin skeins

45. Corpora amylacea
Subpial and perivascular most common location

46. Corpora amylacea Increased with age, Neurodegeneration.
Olfactory bulb, base of brain, spinal cord
Astrocytic inclusion

47. Corpora amylacea
Ubiq
PAS
PAS-positive and ubiquitin-positive

48. Lafora Bodies Lofora Body Disease Polyglucosan Body Disease
Myoclonic epilepsy
Autosomal recessive
Intraneuronal inclusions
Liver biopsy

49. Hirano bodies Hippocampus CA-1, subiculum
Neuronal cytoplasmic inclusion
Actin and actin-related proteins
Non-specific
Increased with age esp. with AD

50. Hirano bodies

51. Hirano Body (x165,000)

52. Granulovacuolar bodies of Simchowicz
Non-specific, increased in aged and esp. AD
Hippocampus CA-1, subiculum, more rarely other

53. Granulovacuolar bodies of Simchowicz
Often multiple
Tau-positive
Unknown composition

54. Marinesco bodies Non-specific Substantia Nigra, LC Aged, Parkinson’s
PAS-neg, pink on Masson’s trichrome

55. Herring Bodies
Posterior pituitary, swollen axons, incidental

56. Herring bodies I

57. Buscaino Bodies Artifact of formalin fixation ?<10%, ?not buffered
Do not mistake for edema or storage disorder

58. Buscaino Bodies
“mucocytes”
PAS-positive

59. Zebra bodies Lysosomal storage disorder
Mucopolysaccharidoses (MPS I, II and III)
Hunter-Hurler, Sanfillipo
Cranial nerve nuceli, liver, skin
PAS-positive, LFB-positive
Water soluble
Rare in metachromatic leukodystrophy

60. Fingerprint bodies Neuronal ceroid lipofuscinosis (NCL, types 1-7)
Batten’s Disease, et al.
Autosomal recessive
PAS-positive
LFB, Sudan Black, Oil-red O
Lipid stains remain in paraffin
Autofluorescent
EM - Skin biopsy, lymphocytes (buffy coat prep)

61. Fingerprint bodies EM
60,000-80,000

62. NCL
Curvilinear bodies
Skin biopsy
Lymphocytes (buffy coat prep)

63. Fingerprint bodies Infantile NCL -
granular osmiphilic deposits (GRODs)
Late-infantile NCL - curvilinear bodies
Juvenile NCL - FINGERPRINT BODIES
Onset age 4-9 years old
pigmentary retinopathy
seizures, dementia, blindness
spastic paraplegia
death age 20-30

64. s I