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Various types of hereditary inclusion body myopathies map to chromosome 9p1-q1.

Hereditary inclusion body myopathies are a clinically heterogeneous group of disorders characterized by adult-onset, slowly progressive muscle weakness and typical histopathology: rimmed vacuoles and filamentous inclusions. The disorders are usually inherited as an autosomal recessive trait. The gene responsible for the disease found in Iranian Jews, who present with quadriceps-sparing myopathy, maps to chromosome 9p1-q1. We address the question of whether hereditary inclusion myopathies are genetically as well as clinically heterogeneous disorders. We mapped the disease gene segregating in two families of Afghani-Jewish and one family of Iraqi-Jewish descent to the chromosome 9 locus. Similarly, the disease gene segregating in a non-Jewish family from India mapped to the same locus. By contrast, the disease gene segregating in a French-Canadian family in which affected individuals had central nervous system involvement as well as hereditary inclusion body myopathy, did not map to this locus. We conclude that many but not all forms of autosomal recessive hereditary inclusion body myopathy are caused by a gene defect that maps to chromosome 9p1-q1.

Adult↗

New inclusion body in a rat renal cell.

BACKGROUND AND METHODS: In an effort to review ultrastructural features of cells in the kidney of a male rat, transmission electron microscopy was used to study ultrathin sections. RESULTS: One light cell in a collecting tubule contained a 2.3-microns long linear array of electron-dense asymmetric structures in a granular zone of greater electron density than the general cytoplasm. This inclusion body could be interpreted to consist of a parallel array of 100-150-nm x 24-nm electron-dense rodlets, or a parallel array of 100-150-nm x 67-nm tubules. The inclusion showed no association with any cell organelle. The origin, chemical nature, frequency of occurrence, and functional significance of this inclusion are unknown. CONCLUSIONS: Although this inclusion body somewhat resembles previously described inclusions or granules, the differences in dimensions, frequency, and relation to other cell structures suggest it is a new observation.

Animals↗

An aromatase-associated cytoplasmic inclusion, the "stigmoid body," in the rat brain: II. Ultrastructure (with a review of its history and nomenclature).

The ultrastructure of aromatase-associated "stigmoid (dot-like) structures," which were detected in a previous study using light-microscopic immunohistochemistry (Shinoda et al.: J. Comp. Neurol. 322:360-376, '92), were examined in the rat medial preoptic region, bed nucleus of the stria terminalis, medial amygdaloid nucleus, and arcuate nucleus by pre- and post-embedding marking with a polyclonal antibody against human placental antigen X-P2 (hPAX-P2) for immuno-electron microscopic analysis. The immunoreactive stigmoid structure was identified as a distinct, non-membrane-bounded cytoplasmic inclusion (approximately 1-3 microns in diameter), which has a granulo-fuzzy texture with moderate-to-low electron density in non-immunostained preparations. It consists of at least four distinct granular and three distinct fibrillo-tubular elements forming a granulo-fibrillar conglomerate. This type of inclusions was formally termed the "stigmoid body" under the electron microscope. The stigmoid body is composed of the outer granulo-fibrillar and inner hyaloplasmic compartments. The immunoreactivity for hPAX-P2 is mainly localized to the former, especially to the low density granulo-fuzzy materials associated with the fibrillo-tubular elements. Identification of the ultrastructure of stigmoid body clarified their prevalence not only in the limbic and hypothalamic regions, but also in sex-steroid-sensitive peripheral tissues (e.g., peripheral sensory ganglia, ovary, testis) by consulting earlier electron-microscopic studies. Reviewing the history and nomenclature of this inclusion body, we reorganized the terminology of related neuronal cytoplasmic inclusions, the terms of which have often been confused, and discussed its functional significance on the basis of the present and previously accumulated data. In conclusion, we emphasized the importance of the stigmoid bodies in the sex-steroid-sensitive neural system because of their large size, high frequency, specific distribution in brains and peripheral tissues, effects of sex-steroids, and immunological and histochemical characteristics of the antibody marking the inclusion. The stigmoid bodies may provide a subcellular site for sex-steroid metabolism in their target tissues and play a critical role in cytosolic modulation of their actions (e.g., by aromatization) prior to their receptor binding.

Amygdala↗

Fine-needle aspiration biopsy and intraoperative cytologic smear findings in a case of benign mesothelial-cell inclusions involving a lymph node: case report and review of the literature.

Although first described over a decade ago, the rare entity of mesothelial lymph node inclusions (nonneoplastic mesothelial cells involving lymph node sinuses) is not well-known among pathologists. Unlike most lymph node inclusions such as Müllerian inclusions or nevus cells, which usually occur in the capsule of the lymph node, mesothelial cells involve the lymph node sinus, mimicking metastatic carcinoma or metastatic mesothelioma. The spectrum of histologic findings ranges from a few mesothelial cells, perhaps only detectable by immunohistochemical stains, to a massive distention of the lymph node sinus with abundant mesothelial cells. Mesothelial-cell inclusions in lymph nodes are usually found in mediastinal lymph nodes of patients with pleural and/or pericardial effusions. It is hypothesized that the effusion, due to whatever cause, allows for mesothelial-cell migration into the submesothelial lymphatics and regional lymph nodes. To our knowledge, cytologic findings on aspiration biopsy and intraoperative smear preparations of a lymph node with mesothelial-cell inclusions have never been described. Familiarity with this entity is important in preventing misdiagnosis of malignancy.

Biopsy, Fine-Needle↗

Amiodarone- and desethylamiodarone-induced myelinoid inclusion bodies and toxicity in cultured rat hepatocytes.

Hepatocytes isolated from Sprague-Dawley rats were incubated with various concentrations of either amiodarone or desethylamiodarone for 0 to 96 hr. Both drugs produced a concentration-dependent increase of lactate dehydrogenase release in the culture medium, which correlated well with cell death as measured by trypan blue exclusion test. Desethylamiodarone was more toxic than amiodarone in the cultured hepatocytes. Incubation with subtoxic concentrations of either amiodarone (7.6 microM) or desethylamiodarone (8 microM) for 24 hr resulted in the development of myelinoid inclusion bodies in the hepatocytes without any excess release of lactate dehydrogenase. In experimental protocols where the hepatocytes were exposed to either amiodarone or desethylamiodarone for up to 96 hr, there was an increase in lactate dehydrogenase and the percent volume-density of multilamellar inclusion bodies with cumulative drug exposure with time. A linear correlation between hepatocyte drug concentration and multilamellar inclusion bodies was found for both amiodarone and desethylamiodarone. These results demonstrate that both amiodarone and its major metabolite, desethylamiodarone, induce lysosomal inclusions, which, under appropriate conditions, can be dissociated from cell death. Withdrawal of the drug after 24 hr exposure did not result in disappearance of the inclusion bodies from the hepatocytes for up to 96 hr of tissue culture. The concentrations at which amiodarone- or desethylamiodarone-induced electron microscopic changes and hepatotoxicity were only two to five times as high as the usual serum drug levels in patients given antiarrhythmic therapy with amiodarone.

Amiodarone↗

Neurofilament-rich intraneuronal inclusions exacerbate neurodegenerative sequelae of brain trauma in NFH/LacZ transgenic mice.

Several neurodegenerative disorders are characterized by filamentous inclusions in neurons that selectively degenerate. The role these inclusions play in neuron degeneration is unclear, but this issue can be investigated experimentally in relevant animal models. The NFH/LacZ transgenic (TG) mice overexpress the high-molecular-weight neurofilament (NF) subunit (NFH) fused to beta-galactosidase, and these hybrid proteins aggregate into NF-rich, filamentous neuronal cytoplasmic inclusions (NCIs) that have been implicated in the progressive, age-dependent degeneration in subsets of affected neurons. Thus, these TG mice recapitulate some of the key pathology of neurodegenerative disorders with intraneuronal inclusions. To determine if the NCIs compromise neuron survival following traumatic brain injury (TBI), 3- to 6-month old TG and wild-type (WT) mice were subjected to TBI or sham injury. At 2 weeks post-TBI, the TG group showed increased TUNEL staining and activated caspase-3 immunoreactivity in cells of cerebral cortex, adjacent white matter, and hippocampus underlying the injury site, relative to control mice, but this labeling decreased at 4 weeks and was minimal thereafter. Compared to control mice, by 8 weeks postinjury, the TG mice showed a marked decrease in neuron density and increased gliosis in the hippocampal dentate gyrus and CA3 region as well as in the lateral thalamus, while the few remaining CA3 neurons exhibited cytoskeletal alterations, decreased synaptic protein immunoreactivity, and dissolution of NCIs. The more profound long-term neurodegenerative sequelae of TBI in the NFH/LacZ mice compared to WT mice suggest that the presence of intraneuronal inclusions may impair the recovery and long-term viability of injured neurons.

Animals↗

Mesothelial pelvic lymph node inclusions mimicking metastatic thyroid carcinoma.

Benign lymph node inclusions are commonly encountered during surgery for gynecologic neoplasms and are potential mimics of metastatic disease. A 52-year-old woman presented with ascites, a complex adnexal mass, and a CA-125 of 1891 units/mL. A staging laparotomy was performed, diagnosing struma ovarii. Pathologic evaluation of pelvic lymph nodes demonstrated mesothelial inclusions in nodal sinuses suspicious for metastatic disease. Immunocytochemical evaluation revealed benign mesothelial inclusions rather than metastatic thyroid carcinoma. Benign mesothelial lymph node inclusions in nodal sinuses are potential mimics of metastatic carcinoma. Their presence in pelvic lymph nodes has not previously been reported. Given the potential difficulty in determining the origin of these inclusions, immunocytochemical evaluation is useful in reaching the correct diagnosis.

Diagnosis, Differential↗

Inclusion bodies.

All viruses in the family Potyviridae which have been studied cytologically (currently 111) induce cylindrical inclusions in host cytoplasm. These inclusions are controlled by portions of the virus genome, therefore, viruses which induce them are related. Viruses in other groups do not induce this type of inclusion. Cylindrical inclusions have come to be recognized as one of the main characteristics of the family Potyviridae. They are used in diagnosis of diseases induced by these viruses. For diagnostic purposes the family can be separated into four subdivisions on the basis of differences in cylindrical inclusion morphologies. Assigning viruses to subdivisions assists in virus identification at the specific and in some instances at the strain level.

Cell Nucleus↗

Morphometric studies on lipid inclusions in Sertoli cells during the spermatogenic cycle in the rat.

The volume and surface area of lipid inclusions often present in the cytoplasm of rat Sertoli cells was measured directly from semi-thin sections of perfusion-fixed testicular tissues using an image analyser linked to a light microscope. Sertoli cell nuclei were used as a reference for comparing any variations in the measured parameters of lipid inclusions during the rat spermatogenic cycle. Volume density of Sertoli cell lipid inclusions was assessed by morphometric analysis of Sertoli cells photographically reconstructed from electron micrographs. Maximum lipid content in Sertoli cells occurred during stages IX-XIV of the spermatogenic cycle, then declined at stages I-III and remained low from stages IV-VIII. The persistence and increase in number of many large Sertoli cell lipid inclusions beyond the stage where spermatid residual bodies are phagocytosed within the Sertoli cells (stage IX) suggests that the synthesis and lipolysis of Sertoli cell lipid inclusions represents an intrinsic functional cycle of the Sertoli cells. Stage-dependent variations in the lipid content of rat Sertoli cells offers morphological evidence that the metabolic duties of the Sertoli cells are synchronised with the spermatogenic cycle to provide local coordination of the proliferation and maturation of the germ cells.

Androgens↗

Eosinophilic cytoplasmic inclusions in sporadic equine motor neuron disease: an electron microscopic study.

Equine motor neuron disease (EMND) is a sporadic, progressive neurodegenerative disorder that has been identified recently in horses of different breeds in North America. The cause is unknown. Pathologic changes which occur in spinal and certain brain stem motor neurons include chromatolysis, swelling, neurofilamentous accumulation, and development of eosinophilic cytoplasmic inclusions. Punctate eosinophilic inclusions, the type usually encountered in degenerating neurons, resembled Bunina bodies at the light microscopic level, but differed in their ultrastructural composition. These and less common but larger juxtanuclear inclusions appeared to be aggregated vesicular residues of membranous organelle degradation. The third kind of eosinophilic inclusion was a marginated derivative of endoplasmic reticulum and consisted of large membrane-bound accumulations of finely granular material. It was concluded that, although the distribution and nature of the lesions in EMND appeared similar to those of human motor neuron disease, none of the equine eosinophilic inclusions duplicated the ultrastructure of Bunina bodies.

Animals↗

Novel eosinophilic inclusion in astrocytes.

Intracytoplasmic and brightly eosinophilic inclusions within neuroglias are reported in a patient with Aicardi's syndrome. Most inclusion-bearing neuroglias were protoplasmic astrocytes in the cerebral cortex. Compared with similar eosinophilic and intracytoplasmic inclusions in other studies using both light and electron microscopy, the inclusions in this report are regarded as being novel and not previously described. Ultrastructurally, the inclusions were composed of electron-dense granules and amorphous substances, and were not surrounded by a limiting membrane. They were numerous in the cerebral cortex, especially in part of the microgyrus, but absent in the deep cerebral white matter, subcortical nuclei, brain stem and the cerebellum. Therefore, they may be closely associated with brain malformation and congenital astrocytic dysfunction. They also suggested a functional difference in protoplasmic astrocytes themselves, according to the differentiation of related gray matter.

Agenesis of Corpus Callosum↗

Rosenthal fibers, eosinophilic inclusions, and anchorage densities with desmosome-like structures in astrocytes in Alzheimer's disease.

Ultrastructural study of the cerebral cortex of nine brains of individuals with Alzheimer's disease (AD) revealed four types of pathological changes of astrocytes. Rosenthal fibers were found in three cases, eosinophilic inclusions in one, anchoraged densities with desmosome-like structures in two, and corpora amylacea in four. In two biopsies, Rosenthal fibers were seen in less than 5% astrocytes, but in a third biopsy with numerous plaques, tangles, and severe neuronal loss, they were present in about 40% of astrocytes. In one case with severe AD pathology and numerous Rosenthal fibers, the cytoplasm of some astrocytes was occupied by inclusions composed of electron-dense granules 3-6 microns in diameter or aggregates of inclusions greater than 12 microns in diameter. Ultrastructurally, they were similar to eosinophilic inclusions observed in Aicardi syndrome and brain malformations. The presence of eosinophilic inclusions in the brain of elderly persons with Alzheimer's disease does not confirm the previous suggestion that this form of astrocyte pathology is typical for protoplasmic astrocytes and developmental brain malformations. Development anchorage densities associated with hemidesmosome-like structures, which reinforce astrocyte cell membranes facing the perivascular space, may reflect adaptation of astrocytes to the complex of changes that occurs in atrophic brain. Morphological changes in astrocytes in areas with numerous plaques and massive infiltration of intercellular space with beta-amyloid fibrils and remnants of neurons and ghost tangles suggest that astrocyte pathology is a late unspecific reaction to the cascade of changes induced by beta-amyloid deposition that causes neuronal degeneration and brain atrophy.

Alzheimer Disease↗

Globular glial fibrillary acidic protein-reactive cytoplasmic inclusions in ependymoma: an immunoelectron-microscopic study.

We report of a 27-month-old boy with a recurrent infratentorial ependymoma; the initial resection was at 14 months of age. Both resection specimens were histologically similar. In addition to neoplastic ependymal cells forming perivascular pseudo-rosettes, a second population of cells with identical nuclear morphology displayed large hyaline, refractile cytoplasmic inclusion, causing these cells to superficially resemble gemistocytic astrocytes. These inclusions demonstrated strong glial fibrillary acidic protein (GFAP) immunoreactivity. Ultrastructurally, the inclusions appeared as fenestrated irregular-shaped bodies with jagged edges and were made up of electron-dense granular material. Although these inclusions superficially resembled Rosenthal fibers, immunoperoxidase stains for ubiquitin and alpha B-crystallin were negative. Immunoelectron microscopy showed that these unusual non-filamentous inclusions were diffusely GFAP positive.

Brain Neoplasms↗

Sporadic motor neuron disease with Lewy body-like hyaline inclusions.

Lewy body-like hyaline inclusions were immunocytochemically and electron microscopically investigated in a patient with sporadic motor neuron disease. The hyaline inclusions were chiefly observed within the perikarya of both normal-looking and chromatolytic anterior horn cells in the lumbar spinal cord, but some were detected in the axons and dendrites. Usually, a single inclusion was found in the perikaryon, but in rare cases two or more were observed. Immunocytochemically, these inclusions were intensely immunostained with anti-ubiquitin antibody. Ultrastructurally, the hyaline inclusions were chiefly composed of randomly arranged linear structures associated with ribosome-like granules, varying from compactly arranged linear densities to more loosely packed ones. They contained scattered vesicles of various sizes and occasionally a focal accumulation of randomly arranged 10-nm neurofilaments or 13-25-nm filamentous structures.

Aged↗

Light, fluorescence, and electron microscopic features of neuronal intranuclear hyaline inclusions associated with multisystem atrophy.

Light, fluorescence, and electron microscopic features of intranuclear hyaline inclusions of neurons associated with multisystem atrophy in a 21-year-old woman are described. The neuronal inclusions resemble Marinesco bodies on light microscopy but differ from the latter in their distribution, autofluorescence, and ultrastructure. They are widespread in almost all central, peripheral, and autonomic neurons and are generally larger than Marinesco bodies. The inclusions emit yellow-green autofluorescence with ultraviolet light between 470 and 530 nm of the spectrum and are ultrastructurally composed of haphazardly arranged, uniform, fine, straight filaments (8-9 nm in diameter). The neuronal inclusions have neither the ultrastructural feature of known viral inclusions nor are associated with virus particles. Their chemical nature and pathogenesis remain to be elucidated.

Adult↗

Ultrastructural observations on the vincristine-induced neuronal crystalloid inclusion in young rats.

Vincristine-induced crystalloid inclusions were examined in the neurons and neuronal processes of young rats by the electron microscope (EM) equipped with a tilting stage. Using a computer system that reproduces three-dimensional organization, an optical transformation method was applied to the microtubules and neurofilaments in an attempt to clarify the morphological appearance and internal pattern of crystalloid inclusions. The dimensional models obtained were compared with actual EM photographs, and the characteristic ultrastructural component and morphology were drawn out. Basically, a crystalloid inclusion is composed of four strands of intermediate 10 nm neurofilaments connected to one another by four side-arms producing a circular profile on a transverse section. These four side-arms seemed to arise from nodules within the filaments at regular intervals simulating a bead-like appearance. These data did not significantly differ from those obtained from EM images. Characteristically, these crystalloid inclusions began to appear 6 h after the administration of 10(-3) M vincristine sulfate and persisted up to a period of 6 days. Beyond that, however, these inclusions were no longer demonstrable suggesting a transient state. This was in contrast to neurofibrillary tangles which appeared to be permanent changes.

Animals↗

"PKU bodies": characteristic inclusions in the brain in phenylketonuria.

The ultrastructure of various inclusions within oligodendroglial cells in the brains from two phenylketonuric patients was studied. Characteristic lamellar, oval, slightly irregular inclusions measured between 0.5 and 2 micra in diameter and were bounded by a single membrane. The longitudinal and transverse lamellae of these inclusions had a distinct pattern. In analogy to lamellated but different inclusions of other diseases, these structures were termed "PKU bodies". Various possibilities that would explain the morphogenesis of the PKU bodies and other inclusions in the oligodendroglial cells, and the significance of these findings, are discussed.

Brain↗

Bronchial carcinoid with paranuclear fibrillary inclusions related to cytokeratins and vimentin.

A bronchial carcinoid with globular intracytoplasmic inclusions is reported. The inclusions stain brown with Grimelius silver impregnation and some show distinct immunoreactivity for chromogranin A. Tumour cells stain positively with antisera to neuron specific enolase, chromogranin A and not with antisera against ACTH, somatostatin or S-100 protein. The cells show distinct immunoreactivity for cytokeratins and vimentin, which is particularly intense in the intracytoplasmic inclusions. Desmin and glial fibrillary acidic protein are absent. Ultrastructural analysis reveals that the inclusions are composed of aggregates of filaments of 8-10 nm of diameter, intrapping a few neurosecretory granules. Immunohistochemical and ultrastructural data support the hypothesis that the inclusions are composed of intermediate filaments, whose metabolism and synthesis have somehow been deranged.

Bronchial Neoplasms↗