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Amyloid angiopathy in a brain biopsy of a suspected haemorrhagic tumour: case report
Author(s) -
Bodi I.,
Achawal S. V.,
Sharr M. M.,
Lantos P. L.
Publication year - 2002
Publication title -
neuropathology and applied neurobiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.538
H-Index - 95
eISSN - 1365-2990
pISSN - 0305-1846
DOI - 10.1046/j.1365-2990.2002.39286_45.x
Subject(s) - cerebral amyloid angiopathy , medicine , pathology , amyloid (mycology) , biopsy , brain biopsy , angiopathy , stereotactic biopsy , magnetic resonance imaging , population , radiology , dementia , disease , diabetes mellitus , environmental health , endocrinology
Amyloid angiopathy (AA), most frequently associated with Alzheimer's disease, may lead to lobar intracerebral haemorrhages. Although AA is common in the elderly population, it is rarely diagnosed in brain biopsy. We report a case of AA with Alzheimer's type changes detected by brain biopsy. Material and methods: A 75‐year‐old female presented with intermittent delusions and confusion for 2 months and mild memory impairment on examination. Computed tomography and magnetic resonance imaging scans revealed an old blood clot in the right frontal lobe and raised the possibility of a tumour. At operation, an organized blood clot with a partly cystic wall was removed. Results: Intra‐operative smear showed an infarct with foamy macrophages without evidence of tumour. Paraffin material revealed a haemorrhagic infarct with thickened leptomeningeal blood vessels being positive for Congo red and amyloid‐β (Aβ). Scattered neuritic plaques and neurofibrillary tangles were also detected by Aβ and tau. Retrospective examination of the smear preparation showed metachromatically stained thickened blood vessels consistent with AA. Conclusions: This case of AA presented with a haemorrhage mimicking a tumour. AA was present even in the smear preparation as diagnosed retrospectively. The possibility of AA should be born in mind in atypical haemorrhagic lesions, particularly in elderly patients.