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 advance of enzyme histochemical options has contributed vastly to wisdom of muscle pathology. even if, those and different new equipment, equivalent to electron microscopy and immunocytochemistry, have in simple terms particularly lately develop into gener best friend on hand for regimen use in histopathology. Muscle biopsy is a normal procedure in medical perform, having been brought by way of Duchenne in 1868 (Arch. Gen. Med. , eleven, 5-179). in spite of the fact that, the needle strategy utilized by Duchenne was once now not often followed, even if Shank and Hoagland defined an analogous process 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 compatible for muscle paintings in reference to workout body structure that the benefits of needle muscle biopsies got here to be favored. due to the fact then, muscle biopsies became a comparatively minor technique. This has resulted in the expanding use of muscle biopsy in medical perform, either for prognosis and for assessing growth in repeated biopsies throughout the process a ailment and its remedy. the complete diversity of enzyme histochemical and ultrastructural histological thoughts might be utilized to those small biopsies and lots of of the older histological staining tools is usually used. This publication is meant to function a pragmatic advisor in muscle pathology, rather for histopathologists, and for these in training.
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Additional info for Biopsy Pathology of Muscle
35, 1268-71. Swash, M. (1982), Muscle spindle pathology. In Skeletal Muscle Pathology (Eds F. Mastaglia and J. N. Walton), Churchill Livingstone, Edinburgh. Swash, M. and Fox, K. , (1972a), The effect of age on human skeletal muscle: studies of the morphology and innervation of muscle spindles. f. Neural. , 16, 417-32. Swash, M. and Fox, K. P. (1972b), Techniques for the demonstration of human muscle spindle innervation in neuromuscular disease. f. Neural. , 15, 291-302. 4 Histological features of myopathic and neurogenic disorders It is usually not difficult to decide whether a muscle biopsy is normal or abnormal.
This method gives increased numerical weight to very large or to very small fibres, the result being expressed as hypertrophy factors or atrophy factors. tm diameter a weight of 3. These weights are divided by the total number of fibres measured. The resulting number is multiplied by 1000 to produce an atrophy factor. A similar method is used to calculate the hypertrophy factor in the same muscle fibres. A simpler method of showing fibre atrophy or hypertrophy is to construct fibre size histograms, expressed as a percentage of the total number of fibres measured.
After fibre necrosis, regeneration can occur either in continuity with the undamaged portions of the fibre ('continuous' repair) or from myoblast formation in the necrotic segment itself ('discontinuous' repair). Regeneration begins at a stage when phagocytosis of necrotic material is still incomplete. At this time mononucleated cells are still abundant in the interstitium around the necrotic fibre. In 'continuous' regeneration, surviving muscle nuclei become enlarged and vesicular about 4 days after injury, and migrate to the centre of the fibre.