Lewy and Hirano Bodies

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The Lewy and Hirano bodies are eosinophilic, cytoplasmic inclusions, derived from the differential expression of particular proteins responsible for selective neuronal vulnerability (51). Lewy bodies are usually spheroid in shape with a dense central core (Fig. 7), and the Hirano bodies may often appear as spindle shaped and fusiform.

Lewy bodies may be present in aged individuals (60 years of age and older) without clinical evidence of PD, but are more numerous in those individuals affected by this disease. Indeed, the accumulation of such bodies, especially in the dopaminergic cells of the locus ceruleus and the substantia nigra, is considered a hallmark of PD (52). The accumulation of larger numbers of Lewy bodies in the cerebral cortical neurons of many demented individuals has led to the identification of a "diffuse Lewy body dementia," in which the severity of the dementia correlates with the increasing number of Lewy bodies (53).

Diffuse Lewy Body Disease

FIGURE 5 Photomicrograph of unstained sections under blue light fluorescence illustrating lipofuscin pigment in neuron somata in cerebral cortex of male Long-Evans rats (50). (A) Young adults (109113 days) (original magnification x32); (B) aged rats (763-972 days) (original magnification x14). Source: Gerontological Society of America.

FIGURE 5 Photomicrograph of unstained sections under blue light fluorescence illustrating lipofuscin pigment in neuron somata in cerebral cortex of male Long-Evans rats (50). (A) Young adults (109113 days) (original magnification x32); (B) aged rats (763-972 days) (original magnification x14). Source: Gerontological Society of America.

Hirano bodies in humans develop as changes related to old age; they are predominant in the hippocampus and more numerous in subjects with dementing illnesses, including Alzheimer's disease, Pick's disease (frontotemporal dementia), and amyotrophic lateral sclerosis (Chapter 7).

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