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Neuro Notes

Tubular Aggregate Myopathy

A 75-year-old male presents with progressive generalized muscle weakness, issues with balance, back pain, as well as numbness and tingling…

By Kelly Mrachek, MD
Fibrous Body, neuro path, arkana laboratories, Muscle biopsy
Neuro Notes

Fibrous Body

A 75-year-old female patient presents with proximal muscle weakness, characteristic skin rash, and dysphagia. Laboratory workup reveals elevated CPK 3500.…

By Kelly Mrachek, MD
congophilic inclusions, sporadic Inclusion Body Myositis, neuropathology, arkana laboratories, neuro notes
Neuro Notes

Congophilic Inclusions

A 68-year-old man presents with insidiously progressive proximal left thigh weakness with atrophy, left foot drop, and right hand grip…

By Kelly Mrachek, MD

Renaut body, neuro notes, muscle biopsy, neuropathology
Neuro Notes

Renaut Body

Figure 1: Cross section of sural nerve with Renaut Body (arrow) and background moderate diffuse axonopathic process. Plastic embedded thick…

By Kelly Mrachek, MD
Denervation MCQ, Denervation type changes, neuropathology, neuro notes, arkana laboratories
Neuro Notes

Denervation MCQ

Frozen section of skeletal muscle stained with nonspecific esterase. (Original magnification: 100x) A 45-year old male firefighter with diabetes mellitus…

By Kelly Mrachek, MD
Satellite Cells, Neuro Notes, neuropathology, arkana laboratories
Neuro Notes

Satellite Cells

An adult patient with proximal muscle weakness presents with CK 4400 and skeletal muscle biopsy of the thigh shows frequent…

By Kelly Mrachek, MD

Nemaline Rods, neuro notes, neuropathology, Dr. Mrachek
Neuro Notes

Nemaline Rods

What are these dark (osmophilic) structures seen in this electron micrograph of skeletal muscle?   These osmophilic structures are Nemaline…

By Kelly Mrachek, MD
sarcomere, Neuro notes, renal pathology, arkana labs, neuropathology
Neuro Notes

Sarcomere Bundles of the A Zone

This weeks interesting image shows the examination of skeletal muscle in cross-section at the level of the A zone by…

By Kelly Mrachek, MD
Tangential Sections Through Three Triads
Neuro Notes

Tangential Sections Through Three Triads

Can you identify the structure(s) identified by arrows in this muscle biopsy?   Tangential sections through three triads (pale T-tubules…

By Kelly Mrachek, MD

Contraction Band Artifact , Neuro Notes, neuropathology
Neuro Notes

Contraction Band Artifact

Contraction band artifact (Hematoxylin and Eosin stained section from formalin fixed paraffin embedded tissue 400x magnification)   This skeletal muscle…

By Kelly Mrachek, MD
myopathy, Sarcoid Myopathy and Vasculopathy, Neuro Notes, neuropathology, arkana laboratories
Neuro Notes

Sarcoid Myopathy and Vasculopathy

What is your diagnosis and how would you characterize the designated lesions in Figures 1 & 2? (Black Arrows) Hematoxylin…

By Kelly Mrachek, MD
grouped atrophy, neuro notes, neuropathology
Neuro Notes

Grouped Atrophy

This skeletal muscle biopsy shows grouped atrophy, which is a finding characteristic of denervation. This morphologic alteration indicates the presence…

By Kelly Mrachek, MD

Neuromuscular Junction, NMJ, Neuro Pathology, myoneural junction, motor end-plate
Neuro Notes

The Neuromuscular Junction

What is the dark staining structure? (Hint: note the small nerve twig associated with the structure). The neuromuscular junction (NMJ;…

By Kelly Mrachek, MD
nerve twigs, Neuro notes, molecular pathology, neuropathology, renal pathology, arkana laboratories
Neuro Notes

Nerve Twigs Within Endomysial Connective Tissue

This week’s Neuro Notes shows ultrastructural examination of a muscle biopsy can sometimes yield additional useful information, such as evaluation…

By Kelly Mrachek, MD
Macrophagic Myofasciitis (MMF), neuro notes, arkana laboratories, neuropathology
Neuro Notes

Macrophagic Myofasciitis (MMF)

This previously healthy pediatric patient presented with peculiar facial muscle hypertrophy, and genetic testing revealed one pathologic variant and two…

By Kelly Mrachek, MD