The electron microscope in modern diagnostic neuropathology

Abstract

Despite its major historical and continuing importance in experimental neurobiology/histology, and its ongoing elucidation of ultrastructural abnormalities in human disease, the electron microscope remains at best an ancillary tool in strictly diagnostic human neuropathology. It is hard to think of any disease of the nervous system or of skeletal muscle in which a diagnosis could not be made without electron-microscopic input. Though diagnostic in many neuropathology conditions, ultrastructural appearances rarely provide the initial diagnosis under the Anatomic Pathology procedures operative in virtually all large modern medical centers. Nevertheless, I shall present three cases in which routine electron microscopy did in fact first indicate the correct diagnosis, to underscore the advisability of routinely taking representative portions of neuropathological specimens for electron microscopy both for immediate diagnostic back-up and for archival and pedagogic purposes.