Fig. 3
From: Inclusion body myositis and associated diseases: an argument for shared immune pathologies
Sjögren syndrome-associated IBM. Pathomorphological characteristics of IBM associated with Sjögren syndrome as seen on muscle biopsy. (a) Myopathic picture with pronounced fiber size variation with hypotrophic and hypertrophic fibers and a diffurse, dense endomysial lymphocytic infiltrates. Gömöri trichrome staining (× 200). (b) Pronounced fiber size variation with hypotrophic and hypertrophic fibers as well as internalized nuclei, myofiber necrosis and endomysial lymphocytic infiltrates and rimmed vacuoles. H&E staining (× 200). (c) Presence of COX-negative, SDH-positive myofibers. COX-SDH staining (× 200). (d) Myofibers display strong sarcolemmal (and sarcoplasmic) positivity for MCH class I. MHC class I staining (× 200). (e) Myofibers display sarcolemmal (and sarcoplasmic) positivity for MHC class II. MHC class II staining (× 200). (f) Coarse p62+ autophagic material mostly localized in vacuoles and subsarcolemmaly with some fibers showing more fine granular autophagic material (× 400). COX  cytochrome oxidase immunohistochemistry; H&E  hematoxylin and eosin; IBM  inclusion body myositis; MHC  major histocompatibility complex; SDH  succinate dehydrogenase