Download Biopsy Pathology of Muscle by Michael Swash M.D. (London), F.R.C.P. (London), M.R.C. PDF

By Michael Swash M.D. (London), F.R.C.P. (London), M.R.C. Path., Martin S. Schwartz M.D. (Maryland) (auth.)

During the final two decades the improvement of enzyme histochemical concepts has contributed vastly to wisdom of muscle pathology. besides the fact that, those and different new tools, resembling electron microscopy and immunocytochemistry, have in simple terms quite lately turn into gener­ best friend on hand for regimen use in histopathology. Muscle biopsy is a normal strategy in medical perform, having been brought via Duchenne in 1868 (Arch. Gen. Med. , eleven, 5-179). notwithstanding, the needle strategy utilized by Duchenne was once now not in general followed, even supposing Shank and Hoagland defined an identical approach in 1943 (Science, ninety eight, 592). in this time muscle biopsies required a surgery and this was once a substantial disincentive to their use. It used to be now not until eventually Bergstrom (1962; Scand. J. Clin. Lab. make investments. , 14, Suppl. sixty eight) and Edwards (1971; Lancet, ii, 593--6) built an easy biopsy needle appropriate for muscle paintings in reference to workout body structure that the benefits of needle muscle biopsies got here to be liked. considering that then, muscle biopsies became a comparatively minor strategy. This has resulted in the expanding use of muscle biopsy in medical perform, either for prognosis and for assessing growth in repeated biopsies through the process a illness and its therapy. the entire variety of enzyme histochemical and ultrastructural histological innovations might be utilized to those small biopsies and lots of of the older histological staining equipment can be used. This publication is meant to function a realistic consultant in muscle pathology, really for histopathologists, and for these in training.

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Duchenne muscular dystrophy. The large, rounded intensely eosinophilic fibres in this paraffin-embedded section have undergone hyaline change. Ultrastructural studies of muscle fibre necrosis have revealed that mitochondrial changes are marked in the early stages. The myofilaments degenerate later, forming amorphous masses of electron-dense material, and the sarcolemmal tubular system becomes disorganized. During macrophage ingestion the myofilaments tend to become broken into small pieces, consisting of A band material; Z and I band material cannot be identified (Fig.

1957). , 1957). Histological and morphometric characteristics 39 Fig. 5. Fibre-type predominance. There is a relative excess of Type 1 fibres. Type 2 fibre atrophy is also a feature of this biopsy. 2 Fat and fibrous tissue The interfascicular planes of normal muscle consist of connective and fibrous tissue, but in most biopsies this plane of tissue is thin. Most muscles also contain thick fibrous planes acting as internal tendons or sites of insertion of muscle fibres but these should not normally be included in a biopsy.

Pacinian corpuscles are only rarely seen in muscle biopsies. (d) Pacinian corpuscle. Silver impregnation; teased preparation x 140. The central part of the receptor contains the sensory nerve fibre, sensitive to pressure deformation. Fig. 6 EM x 44100. Human motor end-plate. The presynaptic, axonal part of the end-plate contains clear, small vesicles (containing acetyl choline). The synapse itself consists of primary and secondary synaptic clefts lined by basement membrane. M, muscle, A, axon. 6 Blood vessels In the neurovascular bundles small arteries and veins may be found.

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