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Currently filtering by tag: inflammatory myopathy

Anti-SRP Myopathy with Chronicity

Anti-SRP Myopathy in neuro muscle biopsy
The patient is an 80-year-old female who presents with chief complaint of progressive proximal muscle weakness and carries a clinical diagnosis of polymyositis for nearly two decades. She was placed on a maintenance dose of steroids and was lost to follow-up for several years. No statin medication is reported.  She was recently admitted after a wellness check revealed that she was unable to ambulate independently.  CPK values ranged from 1500-7700.  A skeletal muscle biopsy of the left thigh was performed.  A follow-up myositis serology panel showed a positive anti-signal recognition particle (+ anti-SRP).  Using the images, what’s your diagnosis for...

Myopathy with Tubular Aggregates

Myopathy with Tubular Aggregates
Considering the clinical vignette from last week (elderly male with proximal muscle weakness). Staining the skeletal muscle biopsy with myoadenylate deaminase (MAD) can give the neuropathologist more information than just it’s presence or absence, as may be seen in adenosine monophosphate deaminase (AMPD) deficiency. Using the images, what other structures or ultrastructural clues can be yielded from myoadenylate deaminase (MAD) staining in this skeletal muscle biopsy?   Frozen sections of skeletal muscle with Tubular Aggregate Myopathy (TAM) demonstrating a cluster of muscle fibers with ovoid eccentric to subsarcolemmal basophilic (blue) inclusions (1) with routine hematoxylin and eosin (H&E) stain, and...

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 in the bottom of his feet.  Physical exam shows motor strength 4+/5 with good tone and without atrophy, asymmetry, or fasciculations.  Hand grip and hip flexor strength is decreased.  Shoulder girdle strength is stable.  Sensory exam shows decreased proprioception, vibration, and light touch.  The patient's past medical history includes peripheral neuropathy, type 2 diabetes mellitus, hyperlipidemia, and hypertension.  Prior alcohol use is reported.  EMG/NCS shows electrodiagnostic findings of polyneuropathy.  CPK is reportedly in the normal range.  Skeletal muscle biopsy is...

Perifascicular Atrophy in Dermatomyositis

Perifascicular Atrophy, neuro notes, Arkana Laboratories, muscle biopsy
What histologic finding is observed in this case?         ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​ ​     ​...