The Workshop on Pathology addressed the following questions and objectives.

1. Lesions which need to be distinguished in the pathological assessment of Lewy body dementia and the methods which should be used in their pathological evaluation.

1. 2. Pathological diagnostic criteria and assessments which should:

1. (a) be applicable to general diagnostic work

2. (b) facilitate clinical correlative research studies

3. (c) anticipate developments in identification of genetic linkages with disease

4. (d) be nonjudgemental in relation to clinical syndromes

1. 3. Key areas for future pathological investigation.

2. 4. The relationship between the different terms which have been used to describe this condition (diffuse Lewy body disease, senile dementia of Lewy body type, Lewy body variant of Alzheimer's disease, cortical Lewy body disease, Lewy body dementia).

Terms of reference

It was agreed that the area of discussion comprised the neuropathology of patients who have cognitive decline associated with the presence of Lewy bodies (LB). For the purposes of the discussion the term ‘dementia with Lewy bodies’ (DLB) was considered most appropriate.

What lesions are significant?

The workshop identified the following pathological features as being relevant to DLB:

The nature of the Lewy body

It was agreed that Lewy bodies were, in general, easily identifiable intracytoplasmic eosinophilic inclusion bodies, being usually spherical but displaying other morphological forms. The terms brainstem, or classical Lewy bodies, were endorsed to describe the inclusions with a hyaline core and pale halo typically seen in nigral and locus coeruleus neurons. The term cortical Lewy body (CLB) was endorsed to describe the less well defined spherical inclusions seen in cortical neurons.