Mitochondrial disease: Cytochrome oxidase deficiency, Child

Muscle fibers with "cracks" & rounded holes

H&E stain

Gomori trichrime stain

"Checkerboard" pattern of fiber types
"Cracks" & rounded holes are
    more prominent in type I fibers

ATPase, pH 9.4
Immature (Intermediate-staining)
Type 2C muscle fibers

ATPase, pH 4.3

Large lipid droplets in many fibers

Sudan black

Toluidine blue

Cytochrome oxidase
  Reduced staining in all fibers

Succinate dehydrogenase (SDH)
  Normal staining

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