Tubular Aggregates and Cylindrical Spirals Have Distinct Immunohistochemical Signatures

Research output: Contribution to journalArticlepeer-review


  • Stefen Brady
  • Estelle G Healy
  • Qiang Gang
  • Matt Parton
  • Ros Quinlivan
  • And 8 others
  • Saiju Jacob
  • Elizabeth Curtis
  • Safa Al-Sarraj
  • Caroline A Sewry
  • Michael G Hanna
  • Henry Houlden
  • David Beeson
  • Janice L Holton

External organisations

  • University of Oxford
  • Queen Elizabeth Hospital Birmingham


Tubular aggregates and cylindrical spirals are 2 distinct ultrastructural abnormalities observed in muscle biopsies that have similar histochemical staining characteristics on light microscopy. Both are found in a wide range of disorders. Recently, a number of genetic mutations have been reported in conditions with tubular aggregates in skeletal muscle. It is widely accepted that tubular aggregates arise from the sarcoplasmic reticulum, but the origin of cylindrical spirals has been less clearly defined. We describe the histopathological features of myopathies with tubular aggregates, including a detailed immunohistochemical analysis of congenital myasthenic syndromes with tubular aggregates due to mutations in GFPT1 and DPAGT1, and myopathies with cylindrical spirals. Our findings support the notion that cylindrical spirals, like tubular aggregates, derive primarily from the sarcoplasmic reticulum; however, immunohistochemistry indicates that different molecular components of the sarcoplasmic reticulum may be involved and can be used to distinguish between these different inclusions. The immunohistochemical differences may also help to guide genetic testing.

Bibliographic note

© 2016 American Association of Neuropathologists, Inc. All rights reserved.


Original languageEnglish
Pages (from-to)1171-1178
Number of pages8
JournalJournal of Neuropathology & Experimental Neurology
Issue number12
Publication statusPublished - Dec 2016
Externally publishedYes


  • Adolescent, Adult, Female, Glutamine-Fructose-6-Phosphate Transaminase (Isomerizing)/genetics, Humans, Male, Middle Aged, Muscle Fibers, Skeletal/pathology, Muscle, Skeletal/pathology, Muscular Diseases/genetics, Myopathies, Structural, Congenital/genetics, N-Acetylglucosaminyltransferases/genetics, Young Adult