Giant Cell Myositis
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General Giant Cells Myopathy Perimysium C5b-9 MRI |
 H&E stain |
Muscle fibers
Varied sizes
Immature fibers: Scattered
Endomysial connective tissue: Increased between muscle fibers
Giant cells
Large
Multinucleated
Locations
Scattered & Clustered
Perimysium & Endomysium
Granulomas: Not definite or None
Perimysium
Widened
Fragmented or Damaged: Some regions
Hypercellular: Including Multinucleated Giant cells
Alkaline Phosphatase: Strong staining
 Congo Red stain |
 H&E stain |
 VvG stain |
 H&E stain |
Muscle fibers
Varied sizes
Immature
Basophilic cytoplasm
Large myonuclei
2C fibers (Intermediate stain at ATPase pH 4.3)(Below)
 ATPase pH 4.3 stain |
 VvG stain |
Wide
Cellular
Structure: Damaged
Granulomas
Alkaline Phosphatase staining
 VvG stain |
 Alkaline phosphatase stain |
 Alkaline phosphatase stain |
Giant Cells
 H&E stain |
 H&E stain |
 Congo Red stain |
Langhans-Type: Nuclei in ring around priphery of cytoplasm (Above, Left)
Torton-type: Nuclei in center of cytoplasm (Above, Right)
Foreign Body-type: Nuclei scattered in cytoplasm (Below)
 Congo Red stain |
 Acid phosphatase stain |
May occur in clusters
 Acid phosphatase stain |
 Acid phosphatase stain |
Acid phosphatase staining in central regions near nuclei
 Acid phosphatase stain |
 Esterase stain |
Esterase diffusely stains cytoplasm of Giant cells
 Esterase stain |
 Esterase stain |
 Gomori trichrome stain |
Gomori trichrome stains cytoplasm of Giant cells red
 Gomori trichrome stain |
 Gomori trichrome stain |
 ATPase pH 4.3 stain |
ATPase stains periphery of Giant cells
 ATPase pH 4.3 stain |
 NADH stain |
Giant Cell Myopathy
C5b-9 StainingPerimysium
Endomysial Capillaries
 C5b-9 stain |
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Patchy, varied involvement of muscles
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11/21/2023