case_images: PMC6649898_01
case_images: Fasciitis in patients with immune-mediated necrotizing myopathy, detected by MRI and en bloc biopsy. (A and B) Gadolinium-enhanced fat-suppressed T1-weighted MRI, showing enhancements (arrowheads) along fasciae and within muscles in patient 1 (anterior tibial muscle) and patient 2 (biceps brachii muscle). (C) Haematoxylin and Eosin staining of the biopsy specimen in patient 2, showing mononuclear infiltrates in lymphoid follicle-like aggregates (arrowhead) and at perivascular sites (arrow) in the fascia in addition to necrosis and regeneration of muscle fibres in fascicles. (D) Immunohistochemical staining of the specimen for patient 2, showing CD4+, CD8+, CD20+ and CD68+ cells in the fascia and muscle.
case_images: rky015f1.jpg
case_images: PMC6649898_02_rky015f1.jpg
case_images: rky015-F1
case_images: Short tau inversion recovery and gadolinium-enhanced fat-suppressed T1-weighted MRI showed abnormal high signal intensity and enhancement, respectively, along the fasciae of the biceps brachii (Fig. 1B) and quadriceps femoris muscles and within these muscles. En bloc biopsy specimens obtained from the biceps brachii muscle before treatment showed muscle fibre necrosis and regeneration, with small numbers of CD68+ macrophages, T and B lymphocytes around the endomysium within the fascicles (Fig. 1C). T and CD8+ T cells, were distributed in lymphoid follicle-like aggregates and at perivascular sites (Fig. 1C and D). The patient was given prednisolone at an initial dose of 40 mg daily in combination with tacrolimus 6 mg/day.
case_images: PMC6649898_02
case_images: Fasciitis in patients with immune-mediated necrotizing myopathy, detected by MRI and en bloc biopsy. (A and B) Gadolinium-enhanced fat-suppressed T1-weighted MRI, showing enhancements (arrowheads) along fasciae and within muscles in patient 1 (anterior tibial muscle) and patient 2 (biceps brachii muscle). (C) Haematoxylin and Eosin staining of the biopsy specimen in patient 2, showing mononuclear infiltrates in lymphoid follicle-like aggregates (arrowhead) and at perivascular sites (arrow) in the fascia in addition to necrosis and regeneration of muscle fibres in fascicles. (D) Immunohistochemical staining of the specimen for patient 2, showing CD4+, CD8+, CD20+ and CD68+ cells in the fascia and muscle.
case_images: rky015f1.jpg
case_images: PMC6649898_02_rky015f1.jpg
case_images: rky015-F1
case_images: Short tau inversion recovery and gadolinium-enhanced fat-suppressed T1-weighted MRI showed abnormal high signal intensity and enhancement, respectively, along the fasciae of the biceps brachii (Fig. 1B) and quadriceps femoris muscles and within these muscles. En bloc biopsy specimens obtained from the biceps brachii muscle before treatment showed muscle fibre necrosis and regeneration, with small numbers of CD68+ macrophages, T and B lymphocytes around the endomysium within the fascicles (Fig. 1C). T and CD8+ T cells, were distributed in lymphoid follicle-like aggregates and at perivascular sites (Fig. 1C and D). The patient was given prednisolone at an initial dose of 40 mg daily in combination with tacrolimus 6 mg/day.