Biopsy Pathology of Muscle

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Each of these categories goes along with certain diagnostic considerations and pitfalls. Individual biopsy features are only rarely pathognomonic. Establishing a firm diagnosis therefore typically requires integration of all of the biopsy findings and relevant clinical information. With this approach, a muscle biopsy can often provide helpful information in the diagnostic workup of patients presenting with neuromuscular problems.

An approach to myopathy for the primary care clinician. Am J Med. Safety and yield of muscle biopsy in pediatric patients in the modern era. J Pediatr Surg. Role of repeat skeletal muscle biopsy: how useful is it? Muscle Nerve. Open muscle biopsy in suspected myopathy: diagnostic yield and clinical utility. Eur J Neurol. The use of muscle biopsy in the diagnosis of systemic vasculitis affecting small to medium-sized vessels: a prospective evaluation in Japan.

Scand J Rheumatol. Diagnostic outcome of muscle biopsy. Allenbach Y, Benveniste O. Diagnostic utility of auto-antibodies in inflammatory muscle. Dis J Neuromuscul Dis. Integrated classification of inflammatory myopathies. Neuropathol Appl Neurobiol. Advances in serological diagnostics of inflammatory myopathies. Curr Opin Neurol. Bohan A, Peter JB. Polymyositis and dermatomyositis second of two parts. N Engl J Med.

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Polymyositis and dermatomyositis first of two parts. Pestronk A. Acquired immune and inflammatory myopathies: pathologic classification. Curr Opin Rheumatol. Novel classification of idiopathic inflammatory myopathies based on overlap syndrome features and autoantibodies: analysis of French Canadian patients.

Neuromuscul Disord.

Muscle biopsy - Wikipedia

Redefining dermatomyositis: a description of new diagnostic criteria that differentiate pure dermatomyositis from overlap myositis with dermatomyositis features. Polymyositis: an overdiagnosed entity. Ann Rheum Dis. Integrated diagnosis project for inflammatory myopathies: an association between autoantibodies and muscle pathology. Autoimmun Rev. J Neurol Neurosurg Psychiatry. Anti-Jo-1 antibody-positive patients show a characteristic necrotizing perifascicular myositis. Nuclear actin aggregation is a hallmark of anti-synthetase syndrome-induced dysimmune myopathy.

Clinical and laboratory features of overlap syndromes of idiopathic inflammatory myopathies associated with systemic lupus erythematosus, systemic sclerosis, or rheumatoid arthritis. Clin Rheumatol. Arthritis Res Ther. Schmidt J.

Current classification and management of inflammatory myopathies. J Neuromuscul Dis. Polymyositis with cytochrome oxidase negative muscle fibres: early quadriceps weakness and poor response to immunosuppressive therapy.

A pattern-based approach to the interpretation of skeletal muscle biopsies

Levine TD, Pestronk A. Inflammatory myopathy with cytochrome oxidase negative muscle fibers: methotrexate treatment. Ragged red fibers in normal aging and inflammatory myopathy. Ann Neurol. Multiple mitochondrial DNA deletions in sporadic inclusion body myositis: a study of 56 patients. Dalakas MC. Inflammatory muscle diseases. Comparative utility of LC3, p62 and TDP immunohistochemistry in differentiation of inclusion body myositis from polymyositis and related inflammatory myopathies. Acta Neuropathol Commun.

C5b-9 deposits on endomysial capillaries in non-dermatomyositis cases. Chahin N, Engel AG. Acta Neuropathol. Diagnostic value of markers of muscle degeneration in sporadic inclusion body myositis. Acta Myol. Broccolini A, Mirabella M. Hereditary inclusion-body myopathies.

Biochim Biophys Acta. Oculopharyngodistal myopathy is a distinct entity: clinical and genetic features of 47 patients. Rimmed vacuoles in Becker muscular dystrophy have similar features with inclusion myopathies. Facioscapulohumeral muscular dystrophy presenting with unusual phenotypes and atypical morphological features of vacuolar myopathy.

J Neurol. Rimmed vacuoles with beta-amyloid and ubiquitinated filamentous deposits in the muscles of patients with long-standing denervation postpoliomyelitis muscular atrophy : similarities with inclusion body myositis. Hum Pathol. Granulomatous myositis: a clinical study of thirteen cases. Clinical correlates of granulomas in muscle.

Pathologic features of muscle in systemic lupus erythematosus: a biopsy series with comparative clinical and immunopathologic observations. Paik JJ. Myopathy in scleroderma and in other connective tissue diseases. Rheumatic and musculoskeletal immune-related adverse events due to immune checkpoint inhibitors: a systematic review of the literature. Arthritis Care Res. A case of myasthenia gravis and myositis induced by nivolumab. Rinsho Shinkeigaku. Focal myositis: a clinicopathologic study of cases of an intramuscular mass-like reactive process.

Am J Surg Pathol. Chronic myopathy associated with anti-signal recognition particle antibodies can be misdiagnosed as facioscapulohumeral muscular dystrophy. J Clin Neuromuscul Dis. Antihydroxymethylglutaryl-coenzyme a reductase necrotizing myopathy masquerading as a muscular dystrophy in a child. A novel autoantibody recognizing kd and kd proteins is associated with an immune-mediated necrotizing myopathy. Arthritis Rheum. Autoantibodies against 3-hydroxymethylglutaryl-coenzyme A reductase in patients with statin-associated autoimmune myopathy.


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Toxic myopathies. Neurol Clin. Mammen AL. Mohassel P, Mammen AL. The spectrum of statin myopathy. Mitochondrial myopathy caused by long-term zidovudine therapy.

Significance of type II fiber atrophy in chronic alcoholic myopathy. J Neurol Sci. Martin F, Peters TJ. Alcoholic muscle disease. Alcohol Alcohol. Metabolic myopathies: a practical approach. Pract Neurol. Approach to the diagnosis of congenital myopathies. Congenital myopathies: Natural history of a large pediatric cohort. Diagnostic approach to the congenital muscular dystrophies. Selcen D. Myofibrillar myopathies. Thornton CA.

Embed Size px. Start on. Show related SlideShares at end. WordPress Shortcode. Full Name Comment goes here. Are you sure you want to Yes No. Anchal Tandon. Mohd Hamza. Shubhra Sharma. Show More. No Downloads. Views Total views. Actions Shares. Embeds 0 No embeds. No notes for slide. Muscle biopsy 1. Rashmi Gujarathi 2. High Low 5. Types of muscle fibresTypes of muscle fibres Type - 1 Type -2 Inc. Between These types done byDiff. Dark Intermediate Light Depend on conc. Diseases ass. General abnormalities of muscleGeneral abnormalities of muscle in response to injuryin response to injury Sprouts of remaining sarcoplasm 2.

Satellite cells — more capacity to regenerate. Regenerating fibres — increased basophilia Nuclei increased in number, larger than normal With vesicular chromatin, prominent nuclei. General causes of atrophy non selective - 1. Denervation- MC 2. Disuse 3. Ischemia 4. Aging 5. Poor nutrition. Changes in histochemical profile:Changes in histochemical profile: Denervation Renervation of different Nv.

Neuromuscular pathology

Causes change in muscle Loss of checkerboard type pattern - Type grouping Motor unit Inflammatory cells invade the endomysium, enveloping necrotic fibres. Sheets of inflamm. Entire wall shows infiltration by inflammatory cells including eosinophils. DM Sarcoidosis-non necrotizing granulomas 2. Idiopathic granulomatous myositis. InflammationInflammation Target Cores Central -pale area: -nce of oxidative enzyme Central-amorphous electron dense material Intermed-Mitochondria Outer- normal Ring fibresRing fibres F Formed by peripheral bundle of myofibril.

Directed circumferentially, encircling inner portion of myofibre. Seen in transverse section.

Signs and symptoms

IBM, distal myopathy, OPD Sarcoplasmic vacuoles Rimmed Vacuole — sharply demarcated vacuole containing granular material that forms red rim in frozen section. Supposed to be autophagic vacuole — membrane bound. Neurogenic atrophyNeurogenic atrophy Diseases affecting lower motor neurons or their axons are- -Amyotrophic lateral sclerosis in adults -Spinal muscular atrophy usually in children -Poliomyelitis - now rare -Peripheral neuropathy of various types Histological changesHistological changes Denervation randomly scattered atrophic fibers Predominantly atrophy of type 2 fibers.

Histological changesHistological changes Denervated muscle fibers Reinnervated by collateral sprouting. DMD Distal myopathyDistal myopathy 1. Welander myopathy 2. Miyoshi myopathy 3. Hereditary variant of IBM 4.