Congenital MG: Agrin mutations

H&E stain Muscle fibers   Varied size   Some internal nuclei

H&E stain

Gomori trichrome stain Varied fiber size

Internal architecture: Irregular in some muscle fibers NADH stain

ATPase pH 9.4 stain Fiber types   Types I & II are small and large   Type IIC fibers are present

ATPase pH 4.3 stain

Neuromuscular junctions: Normal staining Esterase stain

Esterase stain Myotendinous junctions: Irregular shapes extending into muscle fibers
Esterase stain	Esterase stain

Laminin-α2 stain Myotendinous junctions: Stain for sarcolemmal proteins

Dys2 stain

Internal architecture: Desmin aggregates Desmin stain

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6/22/2022