Alzheimer disease and cerebral amyloid angiopathy

Discussion:

There was a concern of a vasculitis in this patient and as a result, they underwent two brain biopsies. 

Histology

Left frontal lobe biopsy. Review of the sections and immunostaining shows strong A-beta protein deposition in the walls of cortical blood vessels. In addition, there are numerous mature plaques with strong A-beta staining. The features are of cerebral amyloid angiopathy and probable Alzheimer's disease. Immunostaining for prion protein is NEGATIVE.

The areas of high T2 signal that resolved (not shown) likely represented cerebral amyloid-related inflammation. 

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