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Macrophagic myofasciitis – Histochemical, immunohistological and spectroscopic findings in a pediatric case
Author(s) -
Specht Charles S,
Katus Matthew C,
Kalasinsky Victor F,
LewinSmith Michael R,
Amato R Stephen S,
Rushing Elisabeth J,
Mullick Florabel G
Publication year - 2007
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.21.5.a399-c
Subject(s) - colocalization , cd68 , immunohistochemistry , periodic acid–schiff stain , chemistry , microbiology and biotechnology , pathology , biology , biophysics , medicine
We studied the muscle biopsy of a 14 month‐old female with macrophagic myofasciitis using histochemistry (HC), immunohistochemistry (IHC), transmission electron microscopy (TEM), scanning electron microscopy with energy dispersive x‐ray analysis (SEM‐EDXA), and Fourier‐transform infrared microspectroscopy (FT‐IR). A perimysial infiltrate of macrophages containing non‐birefringent, periodic acid‐Schiff (+) (diastase‐resistant) and Luxol Fast Blue (‐) granules is present, with a few lymphocytes and no myofiber necrosis. By IHC, these macrophages are CD68 (+), CD163/DR (+), nitric oxide synthase (+/−), CD1a (−), factor XIIIa (−) and S100 (−). Small groups of CD4 (+) or CD8 (+) T‐cells and some CD20 (+) B‐cells are seen. TEM reveals granular and membranous structures in macrophage cytoplasm. No infectious pathogen is identified. By SEM‐EDXA, aluminum and phosphorus colocalize in macrophages; the presence of aluminum has been described with macrophagic myofasciitis. FT‐IR reveals a generalized protein spectrum, along with peaks for C‐O bonds (as may be seen with glycoprotein) and P‐O bonds (as may be seen with phosphate). In this case of macrophagic myofasciitis, aluminum may be bound to glycoprotein or to phosphate in cytoplasmic granules. Glycolipid accumulation is not documented. IHC is consistent with benign macrophages and with a Th1/Th2 immune balance shifted toward Th2.