What Every Neuropathologist Needs to Know: The Muscle Biopsy

• Published in: Journal of neuropathology and experimental neurology Vol. 79; no. 7; pp. 719 - 733
• Main Authors: Nix, James S, Moore, Steven A
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2020; by American Association of Neuropathologists, Inc
• Subjects: Biopsy; Biopsy - methods; Biopsy - standards; Brain research; Care and treatment; Diagnosis; Humans; Invited Review; Methods; Muscle, Skeletal - pathology; Muscle, Smooth - pathology; Nervous system diseases; Neuromuscular Diseases - pathology; Neuropathology - education; Neuropathology - methods; Neuropathology - standards; United States; Neurogenic atrophy; Muscle biopsy; Inflammatory myopathy; Muscular dystrophy; Myopathy
• ISSN: 0022-3069; 1554-6578
• DOI: 10.1093/jnen/nlaa046

Abstract Competence in muscle biopsy evaluation is a core component of neuropathology practice. The practicing neuropathologist should be able to prepare frozen sections of muscle biopsies with minimal artifacts and identify key histopathologic features of neuromuscular disease in hematoxylin and eosin-stained sections as well as implement and interpret a basic panel of additional histochemical, enzyme histochemical, and immunohistochemical stains. Important to everyday practice is a working knowledge of normal muscle histology at different ages, muscle motor units, pitfalls of myotendinous junctions, nonpathologic variations encountered at traditional and nontraditional muscle sites, the pathophysiology of myonecrosis and regeneration, and approaches to distinguish muscular dystrophies from inflammatory myopathies and other necrotizing myopathies. Here, we provide a brief overview of what every neuropathologist needs to know concerning the muscle biopsy.