Department of Pathology, University of Oklahoma Health Sciences Center

NeuroSim Case #01: 60 year- old man with lower limb weakness, pain, and numbness

What are your observations in this picture and how would you proceed with your investigation?

I put this hematoxylin-eosin stained slide here on purpose. Skeletal muscle is very susceptible to the development of artifacts as illustrated in this case. The formalin fixed paraffin embedded sections are the best to look for inflammatory cells which are absent in this case. There is also variation in fiber diameter. Formalin fixed paraffin embedded tissue generates a roughly 30% reduction in fiber diameter. The fibers tend to be angulated and pointed than in frozen sections. The groups of abnormally small fiber as illustrated on the right side of this photograph, however, are not artifact. In fact, they are fiber grouping that are seen in neurogenic atrophy.

Click on thumbnail to see a frozen section of fiber grouping in neurogenic atrophy.

Questions For Comment: KarMing-Fung@ouhsc.edu