![](../pics/biopsy/inflammation/gcm/gcmhelpsm.jpg)
H&E stain
|
Myopathy: Severe
Muscle fibers
Varied sizes
Immature fibers: Scattered
Endomysial connective tissue: Increased between muscle fibers
Giant cells
Large
Multinucleated
Locations
Scattered & Clustered
Perimysium & Endomysium
Granulomas: Not definite or None
Perimysium
Widened
Fragmented or Damaged: Some regions
Hypercellular: Including Multinucleated Giant cells
Alkaline Phosphatase: Strong staining
![](../pics/biopsy/inflammation/gcm/gcmcrlp.jpg)
Congo Red stain
|
![](../pics/biopsy/inflammation/gcm/gcmhelp.jpg)
H&E stain
|
![](../pics/biopsy/inflammation/gcm/gcmvvglp.jpg)
VvG stain
|
![](../pics/biopsy/inflammation/gcm/gcmhemp1.jpg)
H&E stain
|
Myopathy: Severe
Muscle fibers
Varied sizes
Immature
Basophilic cytoplasm
Large myonuclei
2C fibers (Intermediate stain at ATPase pH 4.3)(Below)
![](../pics/biopsy/inflammation/gcm/gcmatp43mp2.jpg)
ATPase pH 4.3 stain
|
![](../pics/biopsy/inflammation/gcm/gcmvvglp4.jpg)
VvG stain
|
Giant Cell Myopathy: Perimysial Connective Tissue
Wide
Cellular
Structure: Damaged
Granulomas
Alkaline Phosphatase staining
![](../pics/biopsy/inflammation/gcm/gcmvvglp5.jpg)
VvG stain
|
![](../pics/biopsy/inflammation/gcm/gcmalpvlp.jpg)
Alkaline phosphatase stain
|
![](../pics/biopsy/inflammation/gcm/gcmalplp.jpg)
Alkaline phosphatase stain
|
Giant Cells
![](../pics/biopsy/inflammation/gcm/gcmhemp2.jpg)
H&E stain
|
![](../pics/biopsy/inflammation/gcm/gcmhemp.jpg)
H&E stain
|
![](../pics/biopsy/inflammation/gcm/gcmcrhp3.jpg)
Congo Red stain
|
Giant Cells
Langhans-Type: Nuclei in ring around priphery of cytoplasm (Above, Left)
Torton-type: Nuclei in center of cytoplasm (Above, Right)
Foreign Body-type: Nuclei scattered in cytoplasm (Below)
![](../pics/biopsy/inflammation/gcm/gcmcrmyop.jpg)
Congo Red stain
|
![](../pics/biopsy/inflammation/gcm/gcmacplp.jpg)
Acid phosphatase stain
|
Giant Cells
May occur in clusters
![](../pics/biopsy/inflammation/gcm/gcmacpmp.jpg)
Acid phosphatase stain
|
![](../pics/biopsy/inflammation/gcm/gcmacphp2.jpg)
Acid phosphatase stain
|
Giant Cells
Acid phosphatase staining in central regions near nuclei
![](../pics/biopsy/inflammation/gcm/gcmacphp4.jpg)
Acid phosphatase stain
|
![](../pics/biopsy/inflammation/gcm/gcmestmp2.jpg)
Esterase stain
|
Giant Cells
Esterase diffusely stains cytoplasm of Giant cells
![](../pics/biopsy/inflammation/gcm/gcmesthp.jpg)
Esterase stain
|
![](../pics/biopsy/inflammation/gcm/gcmesthp2.jpg)
Esterase stain
|
![](../pics/biopsy/inflammation/gcm/gcmgtmp.jpg)
Gomori trichrome stain
|
Giant Cells
Gomori trichrome stains cytoplasm of Giant cells red
![](../pics/biopsy/inflammation/gcm/gcmgthp.jpg)
Gomori trichrome stain
|
![](../pics/biopsy/inflammation/gcm/gcmgthp2.jpg)
Gomori trichrome stain
|
![](../pics/biopsy/inflammation/gcm/gcmatp43lp.jpg)
ATPase pH 4.3 stain
|
Giant Cells
ATPase stains periphery of Giant cells
![](../pics/biopsy/inflammation/gcm/gcmatp43mp.jpg)
ATPase pH 4.3 stain
|
![](../pics/biopsy/inflammation/gcm/gcmnadhhp.jpg)
NADH stain
|
Giant Cell Myopathy
C5b-9 Staining
Perimysium
Endomysial Capillaries
![](../pics/biopsy/inflammation/gcm/gcmc5b9.jpg)
C5b-9 stain
|
Giant Cell Myositis: MRI, Legs
Patchy, varied involvement of muscles
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Giant Cell Myositis
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Neuromuscular Home Page
11/21/2023