Nemaline bodies of skeletal muscle fibers of the neck in a case of pharyngeal cancer

Abstract

Nemaline bodies were found in the regenerating muscle fibers of the neck of a 74-year-old Japanese male with pharyngeal cancer. Histologically, the nemaline bodies were needle-shaped structures and hematoxophilic with phosphotungstic acid-hematoxylin stain. Electron microscopic examination suggested that they arise as extensions of the Z bands. Although nemaline bodies occur in a variety of pathological conditions other than nemaline myopathy, their occurrence in regenerating skeletal muscle fibers invaded by cancer has not been reported previously. The pathogenesis of the nemaline body formation in the present case is discussed.

Sporadic late onset nemaline myopathy and immunoglobulin deposition disease

“…Indeed, nemaline bodies can be found in several neuromuscular disorders other than nemaline myopathy. 13,14 Whether or not nemaline rods diminished in our patient with treatment is not known, as a muscle biopsy was not performed after clinical improvement. In nemaline myopathy, an increase of alpha-actinin has been reported in patients with mutations in the muscle alphaskeletal actin gene (ACTA1).…”

“…The absence of nemaline bodies at a stage when clinical symptoms were already apparent and the muscle biopsy showed myopathic changes may indicate that they occur secondarily in the course of disease. Indeed, nemaline bodies can be found in several neuromuscular disorders other than nemaline myopathy . Whether or not nemaline rods diminished in our patient with treatment is not known, as a muscle biopsy was not performed after clinical improvement.…”

Sporadic late-onset nemaline myopathy with monoclonal gammopathy of undetermined significance

“…It should be noted that NB per se is not specific although its presence is a mandatory finding of nemaline myopathies. NB can be observed also in idiopathic inflammatory myopathies, alcoholic myopathy, advanced stage of muscular dystrophies, hypothyroidism, cancer invasion, and chronic neuropathy like spinal muscular atrophy [37][38][39][40][41][42]. Empirically, a small number of fibers with NB can be seen physiologically if the muscle is biopsied near tendon.…”

Myopathy in Post-Radiation Cervico-Scapular Syndrome

“…However, there has also been a case of nemaline rod myopathy reported by Zamecnik 9 after radiation treatment without chemotherapy for laryngeal squamous cell carcinoma. Interestingly, Kimura et al 6 reported nemaline bodies in muscle after chemotherapy treatment alone of pharyngeal cancer. Kimura suggested that an alteration of myotu-bules and small nerves by infiltrating neoplastic cells may cause a reactive inflammatory process.…”