Cylindrical Spirals
- General
- Reported in 16 patients
- Male > Female
- Adult > Children
- Pathology
- Derive primarily from sarcoplasmic reticulum
- Location
- Subsarcolemmal > Central: Parallel to long fiber axis
- Type 2B fibers
- Histochemical Staining: Similar to Tubular aggregates
- Gomori trichrome: Red
- AMPDA: Dark
- NADH: Mild
- Menadione α-glycerophosphate
- Negative: SDH & COX
- Protein contents
2
- SAR1
: Endoplasmic exit sites
- SERCA1: Longiotudinal sarcoplasmic reticulum
- No DHPR or RYR1
- Ultrastructure
- Tightly packed parallel arrays of single- or double-walled cylinders in sarcoplasm
- Spiral membranous lamellae
- Central cytoplasmic core
- May be
- Continuous with: Tubules or vesicles
- Associated with: Tubular aggregates
- Different from: Concentric laminated bodies in D-2-hydroxyglutaric aciduria
- Disease associations: Not specific
- Myotonia, Cramps, Myalgias
- Epidemiology: 1 family
- Inheritance: Dominant
- Clinical
- Percussion myotonia
- Cramps
- Stiffness: Posteffort
- Myotonic lid lag
- Laboratory
- Muscle: Cylindrical spirals
- Congenital weakness & Epileptic encephalopathy
1
- Epidemiology: 2 French-Antillean & Moroccan sisters
- Clinical
- Birth: Hypotonia
- Weakness
- Psychomotor delay
- Epilepsy
- Laboratory
- Serum CK: Mildly high
- Muscle: Cylindrical spirals
- Melorheostosis

- Behr syndrome
- Mitochondrial myopathy
- Myalgias
- Asymptomatic high CK
Images from: Chunyu (Hunter) Cai

H&E stain
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Gomori trichrome stain
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AMPDA stain
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NADH stain
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References
1. Muscle Nerve 2015;52:895-899
2. J Neuropathol Exp Neurol 2016;75:1171-1178
12/14/2016