Neuromuscular

TUBULAR AGGREGATES

Tubular aggregates: Pathology
  • Cytoplasmic
  • H & E
    • Irregular, internal regions, slits or lakes
    • May be clear, or contain pink material
  • Gomori trichrome
    • Contain red material
    • Location: Central or sub-sarcolemmal
  • VvG stain: Gray
  • NADH-TR reductase: Stain strongly
  • Often in type II > I muscle fibers
  • No reaction with mitochondrial stains
  • Ultrastructure (below): 3 types
Differential Diagnosis



H & E stain
Muscle fibers
  Pink cytoplasmic areas: May contain nuclei
  Irregular-shaped clear regions

H & E stain

Congo red stain


Gomori trichrome stain


Tubular aggregates
  Stain red on Gomori trichrome

Gomori trichrome stain


VvG stain

Tubular aggregates
  Stain gray-black on VvG


NADH-TR reductase (NADH) stain



Tubular aggregates:
  Stain dark on NADH

NADH stain


AMPDA stain

AMPDA stain


ATPase pH 9.4 stain
Tubular aggregates (Pale regions): Are often more common in type 2 muscle fibers

ATPase pH 4.3 stain

Tubular aggregates: Stain for lipid on Sudan black

Sudan black stain

Tubular aggregates: Ultrastructure; 3 types


From T Mozaffar

Return to Myopathies with tubular aggregates

5/23/2016