Neuromuscular

Graft vs Host Disease (GVHD)

Myopathy
Neuropathy


GVH: Neuropathy


Toluidine blue stain
Differential Fascicular Involvement: More axon loss in some regions than others

VvG stain

Neurofilament stain

ATPase pH 4.3 stain

Wallerian Degeneration: Intrafascicular variation


Toluidine blue stain

Toluidine blue stain

Acid phosphatase stain

Immune damage: Other
  Epineurium: Alkaline phosphatase staining
  Perineurium: CD4 cells


Alkaline phosphatase stain

CD4 stain

GVH: Myopathy

Perimysial pathology

H&E stain

Gomori trichrome stain
Perimysium: Fragmented and damaged; Contains scattered large cells.
Muscle fibers neighboring abnormal perimysium: Mildly small.

H&E stain

Gomori trichrome stain

Fragmented perimysium: Contains large histiocytic cells

VvG stain

Muscle fibers at the edge of fascicles, near perimysium, tend to be smaller

NADH stain

Perimysium: Acid phosphatase positive cells

Acid phosphatase stain

Acid phosphatase stain

Acid phosphatase stain
Histiocytic cells in perimysium



Esterase stain

Muscle Fibers
  MHC Class I: Upregulated on all muscle fibers

MHC Class I stain

Capillary Pathology

UEA I stain
GVH: Capillaries
  Pale stained by UEA I
  Number: Reduced; Many muscle fibers with no neighboring capillary
  Size: Mildly large

UEA I stain
Control muscle: Capillaries
  Abundant: Capillaries neighboring most muscle fibers
  Dark stained by UEA I


UEA I stain

UEA I stain

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3/15/2016