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Washington University Experience | MUSCLE | Target Fibers | 1A0Targets (Case 1) H&E 40X copy
Case 1 History ---- An 83-year-old woman with rapidly progressive, asymmetric, sensory and motor deficits in the setting of Calcinosis Cutis Raynaud's Phenomenon Esophageal Dysmotility Sclerodactyly Telangiectasis (CREST) syndrome, with an IgM kappa monoclonal gammopathy, and a history of breast cancer. Electrodiagnostic testing showed a very severe axonal polyneuropathy with some features suggestive of a confluent mononeuropathy multiplex. Serum NfL is elevated at 434 pg/ml. Surgical procedure: Sural nerve and gastrocnemius muscle biopsy. ---- 1A0 The patient had an underlying vasculitis with evidence of recanalization (arrow) involving both nerve and muscle (image shown). The workup to follow focuses on the muscle. (H&E)
