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A pattern-based approach to the interpretation of skeletal muscle biopsies

机译：基于模式的骨骼肌活检解释

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The interpretation of muscle biopsies is complex and provides the most useful information when integrated with the clinical presentation of the patient. These biopsies are performed for workup of a wide range of diseases including dystrophies, metabolic diseases, and inflammatory processes. Recent insights have led to changes in the classification of inflammatory myopathies and have changed the role that muscle biopsies have in the workup of inherited diseases. These changes will be reviewed. This review follows a morphology-driven approach by discussing diseases of skeletal muscle based on a few basic patterns that include cases with (1) active myopathic damage and inflammation, (2) active myopathic damage without associated inflammation, (3) chronic myopathic changes, (4) myopathies with distinctive inclusions or vacuoles, (5) biopsies mainly showing atrophic changes, and (6) biopsies that appear normal on routine preparations. Each of these categories goes along with certain diagnostic considerations and pitfalls. Individual biopsy features are only rarely pathognomonic. Establishing a firm diagnosis therefore typically requires integration of all of the biopsy findings and relevant clinical information. With this approach, a muscle biopsy can often provide helpful information in the diagnostic workup of patients presenting with neuromuscular problems.
机译：肌肉活检的解释很复杂，与患者的临床表现相结合时可提供最有用的信息。进行这些活检是为了检查包括营养不良，代谢性疾病和炎症过程在内的各种疾病。最近的见解导致炎症性肌病的分类发生了变化，并改变了肌肉活检在遗传性疾病检查中的作用。这些更改将被审查。这项审查遵循了一种由形态学驱动的方法，根据一些基本模式讨论了骨骼肌疾病，其中包括（1）主动肌病性损害和炎症，（2）没有相关炎症的主动肌病性损害，（3）慢性肌病性改变， （4）有明显夹杂物或液泡的肌病;（5）活检主要表现为萎缩性变化;（6）在常规制剂中表现正常的活检。这些类别中的每一个都伴随着某些诊断注意事项和陷阱。个别活检特征很少是病理诊断。因此，要确定诊断，通常需要整合所有活检结果和相关的临床信息。通过这种方法，肌肉活检通常可以为患有神经肌肉疾病的患者的诊断检查提供有用的信息。

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