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 &#gt; I muscle fibers
  • No reaction with mitochondrial stains
  • Ultrastructure (below): 3 types
Differential Diagnosis

H & E stain
Irregular-shaped clear regions in muscle fibers

Gomori trichrome stain

Tubular aggregates stain red

VvG stain

Tubular aggregates stain gray-black

NADH-TR reductase (NADH) stain

Tubular aggregates: Stain dark on NADH

Tubular aggregates: In some syndromes more common (Pale regions) in type 2 (Dark) muscle fibers

ATPase pH 9.4 stain

Tubular aggregates: Stain for lipid on Sudan black

Sudan black stain

Tubular aggregates: Ultrastructure; 3 types

From T Mozaffar

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