Lymphocytic B-cell Focal inflammation Focal invasion of muscle fibers IM-VAMP (IBM) Lymphorrhages Myositis Histiocytes Granuloma Muscle fiber necrosis Pathology types Also see: Inflammatory myopathy |
Focal lymphocytic inflammation: Nongranulomatous | |
H&E |
Esterase |
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Differential diagnosis Myopathy General Myopathy: Clinical Pathology Giant cells Muscle Nerve Endoneurial Perivascular Other: Tissue changes Perimysium Tuberculosis |
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Granulomas: Differential Diagnosis
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H&E stain |
Granulomas: Features Focal cell collections Histiocytic cells Location: Central Nuclei: Large Cytoplasm: Prominent Stain with Acid phosphatase: Perinuclear Esterase: Cytoplasm Antibodies: CD68; CD4 Giant cells: Markers Present Lysozyme α1-antichymotrypsin Absent: Myoglobin Lymphocytes Location: Peripheral Nuclei: Small; Dark Cytoplasm: Little Component: γδ T-cells Humoral Factors: associated TNF IL8 |
H&E stain H&E stain |
Congo red stain |
Congo red stain |
Congo red stain Granuloma contains Large histiocytic cells: Have abundant cytoplasm & large nuclei Giant cell |
Gomori trichrome stain |
Acid phosphatase stain |
Acid phosphatase (Above): Stains perinuclear region of granuloma cells This differs from the confluent staining in IMAM cell foci Esterase (Below) shows confluent staining of cells in granulomas |
Esterase stain |
H&E stain |
Granuloma in perimysium Congo red |
Acid phosphatase stain |
H&E stain |
H & E stain Large cells in granuloma |
Esterase stain Confluent staining of cells in granuloma |
Acid phosphatase stain Perinuclear staining of most cells in granuloma |
H&E stain |
H&E stain |
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H&E stain |
Gomori trichrome stain |
Congo red stain |
Acid phosphatase stain |
Erosion of non-necrotic muscle fibers around & along their edges by Histiocytic granuloma cells |
Congo red stain |
Acid phosphatase stain |
MHC expression by muscle fibers & granuloma cells |
Control muscle: MHC expression only in vessels |
Other immune features | |
Alkaline phosphatase staining of perimysium |
CD4 staining of granuloma cells |
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Congo red |
H&E stain |
H&E stain |
Congo red stain |
Acid phosphatase stain |
H&E stain |
H&E stain |
H&E stain |
Acid phosphatase stain |
H&E stain |
Acid phosphatase stain |
Scattered cells in Perimysium MHC Class I stain |
VvG stain Axon loss: Myelinated axons Varied within fascicles |
Acid phosphatase stain Histiocytic perivascular cells |
H&E stain |
Alkaline phosphatase stain |
H&E stain |
Gomori trichrome stain |
Congo red stain |
Acid phosphatase stain |
Acid phosphatase stain |
Toluidine blue stain Axon loss Large & Small myelinated Regenerating clusters: Small, Few |
Toluidine blue stain Cells in Vessel Walls Size: Large Nuclei: Large Cytoplasm: Abundant |
H&E stain |
H&E stain |
Acid fast stain |