Neuromuscular

Hemophagocytic Lymphohistiocytosis (Macrophage Activation Syndrome)


Gomori trichrome stain
Necrotic muscle fibers
  Scattered
  Dark-stained or Pale
  Some are associated with cells

H&E stain
Necrotic muscle fibers

H&E stain

Necrosis Pattern: Scattered Muscle Fibers


C5b-9 stain

Myophagocytosis
Progressive phagocytosis of muscle fibers (from their outside) by large multinucleated cells.
Muscle fibers are necrotic with a hyaline appearance.

H&E stain
Congo red stain

Myophagocytosis: Muscle fiber Pathology


Gomori trichrome stain
Necrotic muscle fibers are pale or dark.
Multinucleated large cells, neighbor necrotic fibers

H&E stain

H&E stain
Necrotic muscle fibers are pale or dark.
Multinucleated large cells, neighbor necrotic fibers

H&E stain

VvG stain
Necrotic muscle fibers are pale or dark.
Multinucleated large cells, neighbor necrotic fibers

VvG stain

VvG stain

NADH stain
Necrotic muscle fibers are pale and have lost NADH staining.
Multinucleated large cells, next to necrotic fibers, may be NADH positive.

NADH stain
 

NADH stain

Alkaline phosphatase stain
Alkaline phosphatase: Hemophagocytic cells stain black.

Acid phosphatase stain
Myophagocytic cells (red) progressively phagocytose & replace muscle fibers..
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8/19/2017