Neuromuscular

BULBOSPINAL MUSCULAR ATROPHY


Patterns of denervation in muscle


H & E stain
Morphology
Small angular atrophic muscle fibers
Grouped muscle fiber atrophy
Hypertrophic muscle fibers
Split muscle fibers
Internal nuclei

Pyknotic nuclear clumps: Large
Necrosis: Scattered large fibers
Regeneration: Clustered muscle fibers

H & E stain

Muscle fibers
  Internal nuclei
  Partial, or incomplete, fusion
  Hypertrophy
  Pyknotic nuclear clumps
 

Muscle fibers: Small & Angular, or Pyknotic nuclear clumps


H & E stain

Esterase stain

Muscle fibers: Grouped atrophy


H&E stain

H&E stain

H&E stain
   
Grouped atrophy
Smaller fibers may be rounded or angular
Large muscle fibers are hypertrophied

VvG stain

Gomori trichrome stain

Esterase stain

Muscle fibers: Internal architecture


NADH stain

NADH stain
Some small fibers are darkly stained
Large muscle fibers
  Coarse internal architecture; Pale centers
  "Splitting" (Partial fusion)(Below)

NADH stain

NADH stain

Muscle: Fiber types


ATPase, pH 9.4

ATPase, pH 9.4

ATPase pH 4.3 stain
Large muscle fibers: Type 1 predominance
Small muscle fibers: Either type 1 or 2
Grouped atrophy: Small regions; Mixed fiber types


ATPase pH 9.4 stain


Neuronal Intranuclear Aggregates


From Mei Li MD
Androgen Receptor in Motor Neuron

From Mei Li MD
Polyglutamine in Motor Neuron

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1/28/2015