ANA: Nucleolar

Staining of the HEp-2 cell nucleoli can be divided into clumpy, homogenous, speckled and rim (artefact?). Frequently the nucleolar staining can appear with other patterns.

ANA: Clumpy nucleolar

Nucleolar pattern
The pattern seen below is clumpy nucleolar and describes the staining appearance of the nucleoli.
HEp2 cells


Antigen
 
fibrillarin (U3-nRNP, 34 kDa)

Clinical
 
Systemic sclerosis (scleroderma), detected in 5-10% of patients.


ANA: Homogenous nucleolar

Nucleolar pattern
The nucleoli are homogenously stained.
HEp2 cells


Antigen
 
PM/Scl is intracellular exosome

Clinical
 
Overlap syndrome (polymyositis / scleroderma) (24%)


ANA: Speckled nucleolar

Nucleolar pattern
The nucleoli have speckled staining.
HEp2 cells


Antigen
 
RNA polymerase 1

Clinical
 
Systemic sclerosis (30%)


ANA: Nucleolar with mitotic dots

Nucleolar pattern
The nucleoli staining is accompanied by dots in the mitotic cells, a characteristic of NOR specificity.
HEp2 cells


Antigen
 
NOR (90 kDa)

Clinical
 
Scleroderma with Raynaud's syndrome 
 

ANA: Nucleolar Rim

Nucleolar pattern
The nature of the nucleolar rim is questionable as it could be an artefact. In any case, below are two examples to share with you.
HEp2 cells
HEp2 cells

Antigen:Unknown
Clinical: undetermined