Muscular pathological features in patients with Lambert-Eaton myasthenic syndrome associated with small cell lung carcinoma.

Abstract

Lambert-Eaton myasthenic syndrome (LEMS) is a kind of autoimmune disease of the neuromuscular junction that is often misdiagnosed as a peripheral nerve disease or myopathy. For some difficult cases, muscle biopsy examination is useful for differential diagnosis. However, studies about the pathological findings of LEMS patients are rare, especially of patients who were diagnosed with small cell lung carcinoma (SCLC). This study aimed to describe several pathological muscle features in patients with LEMS associated with SCLC. The 5 patients enrolled in this study were diagnosed with LEMS associated with SCLC by clinical manifestation, electromyography, and lung biopsy. Muscle biopsies were performed for the patients, and enzyme histopathology was assessed. The hematoxylin and eosin (H & E) stain showed different sizes of fibers, and the shape of atrophic fibers were angular or polygonal. The adenosine triphosphatase (ATPase) stain demonstrated that the majority of atrophic fibers were type II. Type II fiber predominance was observed in case 1 and case 5. Also, scattered muscle fiber necrosis was shown in case 3. Type II fiber atrophy and type II fiber predominance may often be found in patients with LEMS associated with SCLC. Also, scattered fiber necrosis may appear in this disease.