An unusual case of Pick's disease.

A man aged 64, with a history of chronic trichloroethylene intoxication, presented early headache, impairment of memory, and "stehende Redensarten", later on mental deterioration with muteness and oral tendency. He died of bronchopneumonia. The brain was studied by light and electron microscopy. Numerous inflated cells, intraneuronal argentophil Pick bodies and central chromatolysis of neurons were found throughout the cerebral cortex. Widespread diffuse fibrillary gliosis was the finding bearing a striking resemblance to "progressive subcortical gliosis". Severe loss of nerve cells was observed in the temporal lobe (except the posterior of T 1) and moderate or mild loss in the gyrus rectus, insula, gyrus cinguli, and partial areas of the frontal, parietal, and occipital lobes. By electron microscopy, the argentophil Pick bodies consisted of a conglomeration of randomly arranged short 100-150 A filaments, ribosomes, vesicles, mitochondria, and scanty paired helical filaments. The present case was considered to represent a rare case of Pick's disease of the temporo-fronto-parieto-occipital type or panencephalic type.