AANP Case of the Month

Credit: @JaredAhrendsen (for instagram: Jared T. Ahrendsen, MD, PhD, Northwestern University)

- 5-year-old child
- large, variably enhancing mass of the frontal region
- no evidence of extracranial disease
- Histology below
- Differential?
- IHC/stains? #neuropath

Needle Core Biopsy Muscle Clinical History:This 50-year-old patient presented with progressively worsening muscle weakness of one month duration. Their past medical history was significant…

The answer is: Necrotizing Myopathy

To learn more, head to our blog: www.arkanalabs.com/needle-core-...

#neuropath #neuromuscular #neuronotes #pathology

Education At Arkana Laboratories, we put the education of the next generation first! We offer quizzes, a pathology fellowship, and resident rotations.

We have launched four neuropathology quizzes on our website! If you're interested in testing your neuropathology wisdom, head to our site. #neuropathology #neuromuscular #pathology #neuropath #neuronotes

1/ What is the best pathologic diagnosis? Clinical history in thread.

#NeuroNotes #neuropath #pathology #neuromuscularpath

Denervation with Incidental Vascular Amyloid Clinical History:This 76-year-old male presented with complaints of muscle pain. Their past medical history is significant for Sjogren’s syndrome, fibromyalgia,…

The answer is: Denervation (neurogenic atrophy) and incidental vascular amyloid deposition

To learn more, head to our blog: www.arkanalabs.com/denervation-...

#neuropath #neuromuscular #neuronotes #pathology

Toxic Vacuolar Myopathy Due to Hydroxychloroquine Clinical History:This 50-year-old patient presented with a one year history of of persistent muscle weakness. They also had shortness of…

The answer is: Vacuolar myopathy due to hydroxychloroquine toxicity

To learn more, head to our blog: www.arkanalabs.com/toxic-vacuol...

#neuropath #neuromuscular #neuronotes #pathology

1/ This 50-year-old patient presented with a one yearhistory of of persistent muscle weakness. They also had shortness of breath with exertion.

#NeuroNotes #neuropath #pathology #neuromuscularpath

Sporadic Late-Onset Nemaline Myopathy Clinical History:The patient is a 69-year-old male who presented with complaints of proximal lower extremity muscle weakness and BMI of…

The answer is: D.) Duchenne muscular dystrophy

To learn more, head to our blog: www.arkanalabs.com/sporadic-lat...

#neuropath #neuromuscular #neuronotes #pathology

(1/2) The patient is a 69-year-old male who presented with complaints of proximal lower extremity muscle weakness and BMI of 37. His home medication list includes atorvastatin. Bilateral thigh biopsies were performed to evaluate for myopathy.

#NeuroNotes #neuropath #pathology #neuromuscularpath

Tech4Skills Ideathon: ინოვაციური იდეები ტექნოლოგიებში მეტი გოგოს ჩართვისთვის სტატია ქვეყნდება კრეატიული განვითარების ცენტრის ფინანსური მხარდაჭერით. EU4Youth Tech4Skills Ideathon-მა, რომელიც 8-9 ნოემბერს თბილისში გაიმართა, მთელი საქართველოდან 90-ზე მეტი ახალგაზრდა ინოვატორი გააერთიანა, რათა შეემუშავებინათ პრაქტიკული გადაწყვეტილებები, რომლებიც პროფესიულ და ტექნოლოგიურ განათლებას უფრო ხელმისაწვდომს გახდის, განსაკუთრებით კი ქალებისა და გოგოებისთვის. ქალების 56%-იანი ჩართულობით, ღონისძიება იქცა სივრცედ, სადაც ახალგაზრდა ქალები არა მხოლოდ მონაწილეობდნენ, არამედ ხელს უწყობდნენ პროფესიული […]

Collagen Pockets in Nerve Biopsy When small unmyelinated axons are lost to damage, collagen pockets in nerve biopsies are one morphologic sign of axonal loss.

The answer is: Collagen pockets

To learn more, head to our blog: www.arkanalabs.com/collagen-poc...

#neuropath #neuromuscular #neuronotes #pathology

(1/3) This 40-year-old patient underwent sural nerve biopsy to evaluate for a painful mixed large fiber and small fiber axonal neuropathy. The biopsy showed light microscopic features of a chronic active axonopathic process.

#NeuroNotes #neuropath #pathology #neuromuscularpath

Denervated Neuromuscular Junctions Images of a muscle biopsy from this 40-year-old patient showed morphologic and enzyme histochemical features of denervation.

The answer is: The terminal boutons of the motor axons are missing from the neuromuscular junction (NMJ).

To learn more, head to our blog: www.arkanalabs.com/denervated-n...

#neuropath #neuromuscular #neuronotes #pathology

(2/2) What abnormality is seen in the electron microscopic images #1 - #3 of neuromuscular junction present in this patient’s muscle biopsy? For comparison, image #4 is from a normal neuromuscular junction?

#neuropath #neuromuscular

(1/2) Muscle biopsy from this 40-year-old patient showed morphologic and enzyme histochemical features of denervation.

#NeuroNotes #neuropath #pathology #neuromuscularpath #neurosky #pathsky

Ring Fibers The images demonstrate ring fibers with fluorescence with congo red staining under polarized light. Distal muscle weakness, mild myotonia, ring fibers, and mild CK elevation are consistent with myoton...

The answer is: C.) PCR fragment analysis of DPMK

To learn more, head to our blog: www.arkanalabs.com/ring-fibers/

#neuropath #neuromuscular #neuronotes #pathology #pathX

Answer choices:
A.) PCR fragment analysis of CNBP
B.) Muscular dystrophy gene panel
C.) PCR fragment analysis of DPMK
D.) Myositis specific antibody panel

#NeuroNotes #neuropath #pathology #neuromuscularpath #neurosky #pathsky

Which genetic test is required to establish the diagnosis in this 59-year-old with distal muscle weakness, mild myotonia, and persistently elevated CPK values (200-300 U/L)?

#NeuroNotes #neuropath #pathology #neuromuscularpath #neurosky #pathsky

Vacuolar myopathy in 92-year-old male Clinical History:The patient is a 92-year-old-male and presented progressive muscle weakness that began in the left upper extremity and spread…

The answer is: Denervation, reinnervation, and myofibrillar myopathy

To learn more, head to our blog: www.arkanalabs.com/vacuolar-myo...

#neuropath #neuromuscular #neuronotes #pathology #pathX

Hybrid myofibers Clinical History: This previously healthy 35-year-old patient presented with proximal upper and lower extremity weakness and myalgias. Laboratory studies showed…

The answer is hybrid myofibers.
To learn more, head to our blog: www.arkanalabs.com/hybrid-myofi...

#neuropath #neuromuscular #neuronotes #pathology #pathsky

Muscle fiber typing was performed with dual immunohistochemical staining for fast and slow myosin heavy chains (MHCf-brown / MHCs-red).

What do the fibers showing intermediate staining (reddish-brown) represent?

#neuropath #pathology #neuromuscularpath

This previously healthy 35-year-old patient presented with proximal upper and lower extremity weakness and myalgias. Laboratory studies showed normal CPK. The patient's home medication is negative for myotoxic medications.

#NeuroNotes #neuropath #pathology #neuromuscularpath

Season 2 of Visiting Joel is here! This season, we follow visiting physician Dr. Archana Gudipati as she learns more about renal pathology, neuromuscular pathology, and electron microscopy. #pathology #renalpath #neuropath

Click here for episode 1: youtu.be/H-g-G64xsbE

76-year-old with weakness Clinical History:The patient has numerous complaints including weakness, myalgia, arthralgia, back pain radiating down bilateral legs, cramps and twitching, imbalance,…

Correct Answer: Amyloidosis

Head to our blog for a more detailed explanation and additional reading: www.arkanalabs.com/76-year-old-...

#neuropath #neuromuscular #neuronotes #pathology

🎙️ Join us for Grand Rounds on Fri 7/25 at 8:00 AM PT featuring Dr. Meaghan Morris presenting on "Combing Pathology and Spatial Transcriptomics to Investigate Aging and Alzheimer's Disease."

Full schedule here ➨ bit.ly/3BMx0E3

#Pathology #Path2Path #PathSky #neuropath

(1/3) The patient is a 76-year-old man with numerous complaints including weakness, myalgia, arthralgia, back pain radiating down bilateral legs, cramps and twitching, imbalance, speech disorder, difficulty walking, and numbness.

#NeuroNotes #neuropath #pathology #neuromuscularpath

Neuromuscular junction in 60-year-old patient Clinical History: Muscle biopsy was performed on this 60-year-old patient to evaluate for subjective complaints of muscle weakness. Several small…

Diagnosis: Neuromuscular junction (aka motor end-plate)
Head to our blog for a more detailed explanation and additional reading: www.arkanalabs.com/neuromuscula...

#neuropath #neuromuscular #neuronotes #pathology #pathX

Muscle bx was performed on 60 y/o patient w/ complaints of muscle weakness. Several small intramuscular nerve twigs were noted on glutaraldehyde-fixed toluidine blue stained thick sections.

What normal structure is demonstrated in the electron microscopy images?

#NeuroNotes #neuropath #pathology

Image of the Week!

Submitted by: Gabrielle Yeaney, M.D.
Directory Profile: www.pathologyoutlines.com/directory/ga...
Subspecialty: Neuropathology
Diagnosis: Normal pineal gland

#Pathology #PathologyOutlines #NeuroPath #PathSky

A 19-year-old man presented with brain tumor at pineal region and cerebellar region.
AE1/AE3 : weak staining
GFAP: focal near 50%
High Ki-67 proliferative index=60%
What is it?
#neuropath #pathology #pathsky #histology #CNStumor #CNSpath