Biopsy Pathology of MuscleDuring the last 20 years the development of enzyme histochemical techniques has contributed greatly to knowledge of muscle pathology. However, these and other new methods, such as electron microscopy and immunocytochemistry, have only relatively recently become gener ally available for routine use in histopathology. Muscle biopsy is a long-established technique in clinical practice, having been introduced by Duchenne in 1868 (Arch. Gen. Med. , 11, 5-179). However, the needle method used by Duchenne was not generally adopted, although Shank and Hoagland described a similar technique in 1943 (Science, 98, 592). During this time muscle biopsies required a surgical procedure and this was a considerable disincentive to their use. It was not until Bergstrom (1962; Scand. J. Clin. Lab. Invest. , 14, Suppl. 68) and Edwards (1971; Lancet, ii, 593--6) developed a simple biopsy needle suitable for muscle work in connection with exercise physiology that the advantages of needle muscle biopsies came to be appreciated. Since then, muscle biopsies have become a relatively minor procedure. This has led to the increasing use of muscle biopsy in clinical practice, both for diagnosis and for assessing progress in repeated biopsies during the course of a disorder and its treatment. The full range of enzyme histochemical and ultrastructural histological techniques can be applied to these small biopsies and many of the older histological staining methods can also be used. This book is intended to serve as a practical guide in muscle pathology, particularly for histopathologists, and for those in training. |
Contents
Laboratory methods | 14 |
Histological and morphometric characteristics of normal | 34 |
Histological features of myopathic and neurogenic disorders | 47 |
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abnormality acid adult ATPase atrophic fibres axonal basophilic CK level clinical consists dermatomyositis diagnosis Dubowitz Duchenne dystrophy Duchenne muscular dystrophy endomysial Engel enzyme histochemical eosinophilic fascicles fibre atrophy fibre hypertrophy fibre splitting fibre types fibre-type grouping fibres Fig fibrosis glycogen histochemical type histological features hyaline fibres hypertrophied fibres increased central nucleation infiltrates inflammatory cell inflammatory myopathies innervation interfascicular intrafusal muscle fibres lipid droplets longitudinal malignant membrane metabolic myopathies mitochondria mitochondrial myopathies motor end-plates motor neuron disease motor unit muscle biopsy muscle spindles myasthenia gravis myofibrils myopathic change myotonic dystrophy NADH necrotic fibres nerve Neurol neuromuscular disease neuromuscular disorders neuropathies normal muscle nuclei occur pathology patients peripheral polymyositis prominent ragged-red fibres recognized regenerating fibres reinnervation rod bodies sarcoplasm sections skeletal muscle spinal muscular atrophy stain steroid myopathy Swash and Schwartz syndrome Table techniques tumour Type 1 fibres Type 2B usually vacuoles variability in fibre weakness zone