Neuromuscular

MYOTONIC DYSTROPHY

DM1: Chronic changes
DM1: Mild changes
DM2


Myotonic dystrophy (DM1): Chronic changes


H&E stain
  • Numerous internal nuclei: Often in longitudinal chains
  • Myopathic changes: Fiber size variation


Congo red stain
  • Numerous internal nuclei: Often in longitudinal chains


Gomori trichrome stain

NADH stain
Internal nuclei
Disordered internal architecture


Acid phosphatase stain

Acid phosphatase stain
Acid phosphatase positive granules in fibers



Myotonic dystrophy (DM1): Mild changes



Fiber size variation
Internal nuclei in some fibers
Smaller type I (darker) fibers
Disordered internal architecture



Myotonic dystrophy (DM2)


H & E stain

H & E stain
Pyknotic nuclear clumps
Internal nuclei: Multiple


Acid Phosphatase

ATPase pH 9.4
Cytoplasmic granules: Acid Phosphatase positive
Small fibers of both types
Internal nuclei (clear regions) most commonly
in type 2 (dark) muscle fibers


NADH stain

Esterase
Pyknotic nuclear clumps stain darkly


From: Cory Toth MD
Pyknotic nuclear clump: Ultrastructure

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4/28/2010