PMC10184240_01
Portable chest X-ray showing cardiomegaly and mild pulmonary congestion.
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Chest X-ray and computed tomography (CT) angiography of the chest/abdomen/pelvis showed findings suggestive of volume overload with cardiomegaly, small bilateral pleural effusions, distended inferior vena cava and iliac veins, and body wall edema (Figure 1).
Rectus femoris muscle biopsy histopathology: muscle fibers failing to stain with cytochrome c oxidase (20x).
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Mitochondrial myopathy was in the differential diagnosis, and a surgical biopsy of the patient's rectus femoris revealed scattered ragged-blue fibers, scattered ragged-red fibers, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy (Figures 2-4).
Rectus femoris muscle biopsy histopathology: ragged-blue fibers diffusely reactive to succinate dehydrogenase staining (40x).
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Mitochondrial myopathy was in the differential diagnosis, and a surgical biopsy of the patient's rectus femoris revealed scattered ragged-blue fibers, scattered ragged-red fibers, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy (Figures 2-4).
Rectus femoris muscle biopsy histopathology: ragged-red fibers on modified Gomori trichrome stain (40x).
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Mitochondrial myopathy was in the differential diagnosis, and a surgical biopsy of the patient's rectus femoris revealed scattered ragged-blue fibers, scattered ragged-red fibers, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy (Figures 2-4).