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Early age Mild Myopathic groups Regeneration Severe Later age Dystrophin Revertants General features |
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![]() From: AG Engel Delta Lesions (Arrow)
Description: Focal wedge-shaped lesions Locations: Subsarcolemmal regions of muscle fibers |
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![]() H&E stain |
![]() VvG stain |
![]() NADH stain |
![]() ATPase pH 4.3 stain |
![]() H & E stain |
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Muscle fibers Sizes: Varied; Small fibers are rounded or polygonal; Occasional hypertrophic fiber Necrosis (Left): Fibers scattered & in small groups Myopathic groups (Below): Clusters of small necrotic (Black arrow) & regenerating (White arrow) muscle fibers Internal nuclei: Occasional Endomysial connective tissue: Normal to mildly increased Perimysium: Early replacement by fat |
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![]() Acid phosphatase stain Acid phosphatase + cells Endomysium: Small Scattered cells Necrotic muscle fibers: Clusters of phagocytic cells Ring fibers (Arrow) |
![]() Acid phosphatase stain Acid phosphatase + cells Necrotic muscle fibers: Clusters of phagocytic cells |
![]() H&E stain |
![]() Gomori trichrome stain |
![]() VvG stain |
Muscle fiber Stages Necrosis Regeneration Early Late |
![]() H&E stain |
![]() NADH stain Necrotic muscle fibers are pale on NADH stain |
![]() VvG stain |
![]() VvG stain |
![]() H & E stain |
![]() ATPase, pH 4.3 |
![]() NADH |
![]() Clusters of small cells Many stain for Acid phosphatase ![]() Acid phosphatase |
![]() Acid phosphatase |
![]() H & E stain |
![]() H & E stain |
![]() H & E stain Immature fibers are small & basophilic |
![]() ATPase, pH 4.3 Immature fibers are: Small & 2C (Intermediate staining) |
![]() Alkaline phosphatase Immature small fibers have: Cytoplasmic staining |
![]() NADH Immature fibers have coarse cytoplasmic staining |
![]() NADH |
![]() VvG Immature small fibers have coarse cytoplasmic staining |
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Staining properties of immature muscle fibers includes: 1. H & E (left): Basophilic fibers 2. Alkaline phosphatase positive (center) 3. 2C fibers: Intermediate staining on ATPase pH 4.3 (right) |
![]() H&E stain |
![]() H&E stain |
![]() ![]() H&E stain |
![]() Gomori trichrome stain |
![]() Gomori trichrome stain |
![]() VvG stain |
![]() ATPase pH 4.3 stain |
Endomysial connective tissue Fat replacement Fiber types Internal architecture Necrotic fibers |
![]() H&E stain |
![]() H&E stain |
![]() VvG stain |
![]() Sudan stain |
![]() Sudan stain |
![]() H&E stain Endomysial connective tissue: Increased Fiber size: Variable Small fibers: Rounded Large or hypercontracted muscle fibers: Scattered Necrotic fibers (Arrow): Scattered |
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![]() H&E stain ![]() Endomysial connective tissue Increased between fibers |
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![]() ATPase pH 4.3 stain |
![]() Acid phosphatase stain |
![]() NADH stain |
![]() H&E stain |
![]() Gomori trichrome stain |
![]() NADH stain |
![]() NADH stain |
Normal![]() |
Duchenne Muscular Dystrophy:![]() ![]() |
Normal dystrophin staining around the rim of muscle fibers. |
Absent dystrophin: Duchenne muscular dystrophy Left: No staining around the rim of any muscle fibers Right: No staining of most muscle fibers One "revertant" fiber with dystrophin staining. Revertant fibers reflect a somatic mutation allowing dystrophin expression |
Normal: Dystrophin present near surface of muscle fibers ![]() Dys1 stain Duchenne MD: Dystrophin absent from surface of muscle fibers ![]() Dys1 stain |
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![]() from Novocastra Lane 1: Becker dystrophy; Dystrophin has reduced abundance but normal size. Lane 2: Becker dystrophy; Dystrophin has reduced size and abundance. Lane 3: Normal; Dystrophin has normal size and amount. Lane 4: Duchenne dystrophy; Almost no protein is present. Lane 5: Duchenne outlier; Dystrophin has severely reduced abundance. |