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: Stain strongly
  • ATPase: Often in type II > I muscle fibers
  • Sudan: Tubular aggregates contain lipid
  • AMPDA: Stain strongly
  • Mitochondrial stains: No reaction
  • 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

Gomori trichrome stain
Tubular aggregates: May have elongated or rounded shapes

Gomori trichrome stain

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
Tubular aggregates: Contain AMPDA

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

Sudan black stain
Tubular aggregates: Stain for lipid on Sudan black

Sudan black stain

Tubular aggregates
  May have mild or patchy staining for Acid Phosphatase

Acid Phosphatase stain

Tubular aggregates: Ultrastructure; 3 types

From T Mozaffar

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