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Archive: May 2021

Neuromuscular Junctions

Neuromuscular Junctions
Neuromuscular junctions in normal skeletal muscle.  Esterase preparation (A) darkly highlights neuromuscular junctions (NMJs) along a small intramuscular nerve twig.  Original magnification:  A. Nonspecific Esterase Preparation, 100x.   A relatively young patient presented with hypotonia. Course features were noted on physical exam; however, multiple studies revealed no etiology for the patient’s clinical picture. A muscle biopsy was pursued to evaluate for myopathy.  Using Figure 1, what structures (black arrows) are highlighted by the esterase stain shown below?   Answer: Neuromuscular Junctions  Nonspecific esterase preparation is one of the principal enzymatic histochemical stains used to evaluate neurogenic pathology in skeletal muscle...

Twitter Poll (May 27, 2021)

  Answer: PAS-positive The typical histologic features of casts seen in cases of light chain cast nephropathy show light chain restriction by immunofluorescence, are typically PAS-weak or negative in their staining, show fracturing, and will classically show an associated intratubular cellular reaction. Typically these casts will involve the distal tubules and collecting ducts and occasionally, crystal formation can occur.          

Mindfulness Matters

Mindfulness Matters Wellness Class
Mindfulness matters! Tanesha Forrest taught breathing techniques and stretching poses during today’s wellness class to help us be more mindful throughout our day. We definitely feel more relaxed.  

Diagnose This (May 25, 2021)

hronic active antibody-mediated rejection biopsy at arkana laboratories
In an allograft biopsy, what would be your diagnosis for this combination of findings?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​...

Alkaline Phosphatase in Muscle Biopsies

Alkaline Phosphatase in Muscle Biopsies
An elderly female in her mid-70’s presents with insidiously progressive severe proximal muscle weakness over the last two to three months to the point that her symptoms of weakness have interfered with her activities of daily living (ADLs) and are also causing her to have limited ambulation. The patient had been on a statin medication for a number of years without issue, and the dosage had recently been increased.  Hospital admission showed markedly elevated CPK levels that peaked at CPK ~ 7500 and had moderate downward trend with supportive care.  Steroid medication was held until after muscle biopsy of the...

Episode 16: Doing the Best You Can

What's So Special About Renal Pathology, first impressions, Keep Good Company, Stick to Your Knowledge, Never Be Afraid To Ask Questions, Making Time, How to Build A Reputation, Doing the Best You Can, Know Who Is In the Audience, Expanding the Differential Diagnosis, Knowing What Is Normal, Answer the Question, Knowing What You Know, Looking At Every Component, gestalt diagnosis, going deep, examining all the material, Lumping or Splitting, Focus, Using Therapy to Guide a Diagnosis, knowing the therapy, Severity of Change, principles of pathology, representativeness, arkana labs, renal path
How do you handle being pulled in multiple directions as a pathologist? In Episode 16 of Principles of Pathology, Dr. Silva discusses how to effectively multitask and doing the best you can in high-stress situations.  

20th Anniversary Party

We're so thankful for vaccines that allow us to safely gather again. This past Saturday we celebrated our 20th anniversary with friends and family. Thanks to The Rail Yard for hosting us. A great time was had by all!