Difference between revisions of "Neuromuscular pathology"
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Jensflorian (talk | contribs) (+granulomatous myositis & others....) |
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[[Image:Vasculitic neuropathy - plastics - low mag.jpg|thumb|right|[[Micrograph]] of a | [[Image:Vasculitic neuropathy - plastics - low mag.jpg|thumb|right|[[Micrograph]] of a nerve biopsy. [[Toluidine blue stain]].]] | ||
'''Neuromuscular pathology''' is the study of muscle and neurologic disease associated with muscle dysfunction. It is a part of [[neuropathology]]. | '''Neuromuscular pathology''' is the study of muscle and neurologic disease associated with muscle dysfunction. It is a part of [[neuropathology]]. | ||
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*Groups of small fibres. | *Groups of small fibres. | ||
*Apparent increase of nuclei. | *Apparent increase of nuclei. | ||
<gallery> | |||
File:Muscle angular atrophic fibers.jpg | Angulated atrophic fibers (HE) | |||
File:ATPase targetoid fibers neurogenic muscle atrophy.jpg Fiber type grouping and targetoid fibers in neurogenic atrophy (ATPase) | |||
</gallery> | |||
Myogenic: | Myogenic: | ||
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*Endomysial fibrosis. | *Endomysial fibrosis. | ||
*Hypercontracted fibres (large muscle fibres). | *Hypercontracted fibres (large muscle fibres). | ||
<gallery> | |||
File:BMD histology.jpg | Becker's muscular dystrophy ([[H&E])) | |||
File:Dys1 Dystrophinopathy carrier.jpg | Carrier status in dystrophinophathy (Dystrophin) | |||
</gallery> | |||
Images: | Images: | ||
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Notes: | Notes: | ||
*Can be demonstrated with [[IHC]]. | *Can be demonstrated with [[IHC]]. | ||
===DDx=== | ===DDx=== | ||
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*[[Inclusion body myositis]]. | *[[Inclusion body myositis]]. | ||
*[[Dermatomyositis]]. | *[[Dermatomyositis]]. | ||
<gallery> | |||
File:Neuropathology case XII 01.jpg | Polymoysitis ([[H&E]]) | |||
File:Neuropathology case XII 02.jpg | Polymoysitis ([[H&E]]) | |||
File:Neuropathology case XII 03.jpg | Polymoysitis (CD45) | |||
File:Neuropathology case XII 04.jpg | Polymoysitis (MHC-I) | |||
File:Polymyositis_HE.jpg | Polymoysitis ([[H&E]]) | |||
</gallery> | |||
Images: | Images: | ||
*[http://neuromuscular.wustl.edu/pathol/inflammation.htm#cellinv Focal invasion of lymphocytes (wustl.edu)]. | *[http://neuromuscular.wustl.edu/pathol/inflammation.htm#cellinv Focal invasion of lymphocytes (wustl.edu)]. | ||
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**Endomysial - T cells. | **Endomysial - T cells. | ||
**Perimysial - B cells. | **Perimysial - B cells. | ||
==Inclusion body myositis== | |||
<gallery> | |||
File:IBM rimmed vacuoles HE x200.jpg | Rimmed vacuoles in inclusion body myositis (HE). | |||
</gallery> | |||
==Granulomatous myositis== | |||
===General=== | |||
Etiology:<ref>{{Cite journal | last1 = Prieto-González | first1 = S. | last2 = Grau | first2 = JM. | title = Diagnosis and classification of granulomatous myositis. | journal = Autoimmun Rev | volume = 13 | issue = 4-5 | pages = 372-4 | month = | year = | doi = 10.1016/j.autrev.2014.01.017 | PMID = 24424169 }}</ref> | |||
* [[Sarcoidosis]] | |||
* Idiopathic | |||
* Infectious ([[Tuberculosis]], Syphillis, Brucellosis | |||
* Foreign-body reaction | |||
* [[Thymoma]] - myasthenia gravis | |||
* [[Lymphoma]] - paraneoplastic | |||
* [[Primary biliary cirrhosis]] | |||
<gallery> | |||
File:Sarkoidosis muscle.jpg | Sarcoidosis ([[H&E]]) | |||
File:Granulomatous myositis.jpg | Granulomatous myositis ([[H&E]]) | |||
</gallery> | |||
==Metabolic myopathy== | |||
===Microscopic=== | |||
Fetures: | |||
*Intramuscular storage deposits. | |||
** PAS positive stain in glycogen storage disease. | |||
<gallery> | |||
File:PAS glycogen storage disease intermed mag.jpg | Glycogen storage (PAS). | |||
File:Trichrom glycogen storage disease intermed mag..jpg | Glycogen storage (Trichrom). | |||
File:Vacuolar myopathy mcArdle type V glcogenosis.jpg | Type V glocogenosis (McArdle, HE). | |||
</gallery> | |||
==Myotonic dystrophy== | ==Myotonic dystrophy== | ||
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*A type of congenital myopathy. | *A type of congenital myopathy. | ||
*Paediatric thingy. | *Paediatric thingy. | ||
==Centronuclear myopathy== | |||
*AKA myotubular myopathy | |||
*Several types | |||
** X-chromosomal recessive: floppy infant | |||
** austosmal dominant: late onset with proximal involvement, ptosis, opthalmoplegia | |||
<gallery> | |||
File:Biopsy centronuclear myopathy HE.jpg | |||
</gallery> | |||
Image centronuclear myopathy<ref>URL: [http://www.igbmc.fr/recherche/Dep_NG/Eq_JLaporte/JL3.html http://www.igbmc.fr/recherche/Dep_NG/Eq_JLaporte/JL3.html]. Accessed on: 26 October 2010.</ref>). | |||
==Drug-induced rhabdomyolysis== | ==Drug-induced rhabdomyolysis== | ||
*AKA ''drug-induced acute necrotizing myopathy''. | *AKA ''drug-induced acute necrotizing myopathy''. | ||
===General=== | ===General=== | ||
Clinical:<ref name=pmid15021204>{{Cite journal | last1 = Coco | first1 = TJ. | last2 = Klasner | first2 = AE. | title = Drug-induced rhabdomyolysis. | journal = Curr Opin Pediatr | volume = 16 | issue = 2 | pages = 206-10 | month = Apr | year = 2004 | doi = | PMID = 15021204 }}</ref> | Clinical:<ref name=pmid15021204>{{Cite journal | last1 = Coco | first1 = TJ. | last2 = Klasner | first2 = AE. | title = Drug-induced rhabdomyolysis. | journal = Curr Opin Pediatr | volume = 16 | issue = 2 | pages = 206-10 | month = Apr | year = 2004 | doi = | PMID = 15021204 }}</ref> | ||