Aberrant myelinated neurites in the anterior horns of a patient with amyotrophic lateral sclerosis.

A case of amyotrophic lateral sclerosis revealed the classical pathologic features of ALS, i.e. neuronal loss in the anterior horns and pyramidal tract degeneration. In addition to the pathological hallmarks of Alzheimer's disease, senile plaques, neurofibrillary tangles and granulovacuolar changes of neurons were also present. Clinically the 67-year-old patient exhibited ALS of the upper extremity and a mild forgetfulness. Two striking pathological features were noted in the spinal cord: first, at several levels in the spinal cord excessive amounts of myelinated neurites were found; second, the microglial proliferation in the anterior horns was very intense and positive for leukocyte common antigen.