49-Year-Old Man with Limb Weakness and Painful Skin Lesions
Fig. 20.1 Calciphylaxis. (a), A picture of the patient’s back shows a large area of skin eschar (arrows). (b), Muscle biopsy with HE stain shows calcification of media tunica and…
40-Year-Old Man with Muscle Pain and Fatigue
Fig. 18.1 Hematoxylin and eosin stain (HE) shows a rare atrophic fiber (arrow) Final Diagnosis Mild Toxic Myopathy Induced by Statin Use Patient Follow-up The diagnosis of a mild toxic…
58-Year-Old Man with Hypercapnic Respiratory Failure
Fig. 16.1 HE stain shows increased internalized nuclei, a few necrotic fibers and myophagocytosis (a, arrows), and several fibers containing blue-rimmed sarcoplasmic vacuoles (b, arrows). Acid phosphatase stain shows a…
37-Year-Old Woman with Leg Weakness and CK Elevation
Fig. 14.1 Lipid storage myopathy. (a), HE stain shows many fibers containing multiple small sarcoplasmic vacuoles . Gomori trichrome stain (GT) shows these vacuoles are not red rimmed; a few…
75-Year-Old Man with Slowly Progressive Leg and Hand Weakness
Fig. 6.1 Inclusion body myositis. Hematoxylin & eosin stain (a) shows lymphocytic invasion into viable myofibers. Gomori trichrome stain (b) shows a myofiber with sarcoplasmic red rimmed vacuole. COX/SDH stain…
28-Year-Old Woman with Proximal Limb Weakness and Scapular Winging
Fig. 11.1 Quadriceps muscle biopsy shows mild chronic active myopathy . (a), Chronic features include marked fiber size variation, split fibers (black arrows) and frequent internalized nuclei (white arrows). (b),…
33-Year-Old Woman with Pain and Swelling in the Right Calf and Persistent Fever
Fig. 10.1 Necrotizing granulomatous fasciitis and myositis with the presence of AFB positive micro-organisms. Muscle cross sections with hematoxylin and eosin (HE) and acid fact bacilli (AFB) stains show necrotizing…
63-Year-Old Woman with Debilitating Muscle Pain
Fig. 9.1 H&E stain (a and b) shows transmural inflammation involving several perimysial blood vessels (arrows), destruction of blood vessel walls with deposition of fibrinoid material (asterisks), and occlusion of…
61-Year-Old Woman with Progressive Distal Limb and Deltoid Muscle Weakness
Fig. 8.1 Non-caseating granulomatous myositis . Muscle cross sections stained with hematoxylin & eosin (HE) show several endomysial and perimysial granulomas (red arrows) consisting of multinucleated giant cells (green arrow)…
20-Year-Old Man with Acute Multi-organ Failure and Rhabdomyolysis
Fig. 4.1 (a) HE stain shows a rare atrophic fiber (arrow) but no myofiber necrosis or inflammation. (b) ATPase pH 9.4 stain shows normal fiber type distribution with no vacuolar…
