Tuesday, March 17, 2009
A teenager with tau-positive neurofibrillary tangles? What's going on?
Last week I wrote about the College of American Pathologist's neuropathology teaching cases. As an example of the kind of cases presented through this subscription, let me present to you photomicrographs from the most recent edition. Dr Roger McClendon from Duke (pictured above) provided a case wherein a teenager harbors cortical neurofibrillary tangles, vaguely evident in center of this H&E-stained slide:
The patient does not have Down's syndrome or any other reason to have Alzheimer's disease at this young age. And to prove that these are Alzheimer-like tangles, tau immunohistochemistry on the surgical specimen shows that these tangles are indeed tau-positive inclusions:
So? What's going on? See the comment to this post for the diagnosis and explanation.