Neuromuscular

CHRONIC PARTIAL DENERVATION OF MUSCLE

Muscle
  Capillary pathology
  Fiber type grouping
  Grouped atrophy
  Internal nuclei
  Necrotic & Clustered muscle fibers
  Pseudomyopathic changes
  Pyknotic nuclear clumps
  Split muscle fibers
Nerve
  Regenerating axon clusters

Groups (Size): Hypertrophic & Atrophic Muscle fibers



H & E stain
Clusters, or groups, of large, intermediate & small sized muscle fibers

H & E stain
Grouped atrophy: Increased space between tiny muscle fibers

Gomori trichrome stain


VvG stain
Internal architecture: Hypertrophic muscle fibers have Irregular clear centers or Targets

NADH stain


ATPase pH 9.4 stain
Large muscle fibers: All type 1

ATPase pH 4.3 stain

PYKNOTIC NUCLEAR CLUMPS


Also see
Pyknotic nuclear clumps: Morphology

H & E stain

H & E stain

 

H&E stain

Pyknotic nuclear clumps: High magnification

Congo red stain

Congo red stain

Pyknotic nuclear clumps: May also contain lipofuscin

H&E stain

Congo red stain

Pyknotic nuclear clumps: Grouped atrophy

H&E stain

H&E stain

Congo red stain

Pyknotic nuclear clumps: Stain dark with esterase & NADH

NADH stain

Esterase stain
Angular fibers: Esterase
Esterase stain

Pyknotic nuclear clumps: With lipofuscin

Acid phosphatase stain

Acid phosphatase stain

PSEUDOMYOPATHIC CHANGES


H&E stain

Gomori Trichrome stain
  • Endomysial connective tissue: Increased
  • Internal nuclei: One or several in muscle fibers
  • Pyknotic nuclear clumps
  • Grouped atrophy of muscle fibers
    • Groups are less well demarcated than in ongoing denervation
    • Increased endomysial connective tissue is especially prominent in these regions
  • Small muscle fibers may be rounded or angular
  • Hypertrophic muscle fibers: Common

SPLIT MUSCLE FIBERS

INTERNAL NUCLEI


H&E stain

NADH stain

H&E stain
  • "Split" muscle fibers probably result from partial fusion of regenerating fibers
  • These split muscle fibers are very large (hypertrophic)
  • Split muscle fibers often have internal nuclei

NECROTIC & CLUSTERED MUSCLE FIBERS


H&E stain
  • A hypertrophied muscle fiber may become necrotic (left)
  • Several different muscle fibers regenerate in its place and cluster within the old basal lamina


UEA I stain
Capillaries: Chronic Partial Denervation
  Increased numbers of capillaries adjacent to each muscle fiber
  Abnormal orientation: Some become circumferential around muscle fibers

UEA I stain

Return to Muscle biopsies
Return to Biopsy illustrations
Return to Neuromuscular home page
Return to Polyneuropathy Index

11/14/2016