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Mitochondrial Abnormalities

Jon Wilson, MD neuropathologist at arkana laboratories
By Jon Wilson, MD

Jul 29, 2022

combined COX/SDH stained frozen section 100x original magnification

The patient is a 35-year-old female who presents with complaints of fatigue. The patient’s past medical history is significant for deafness and ventricular tachycardia. Her family history is significant for similar symptoms in her mother.

Abnormalities of which of the following are seen in Figures #1 – #5?

A. Nuclei

B. Mitochondria

C. Lysosomes

D. T-tubules




Correct Answer: Mitochondria

The features seen on light and electron microscopy reflect abnormalities of mitochondria. The appearance of the abnormal muscle fibers on modified Gomori Trichrome is also referred to as “ragged red muscle fibers.” The loss of COX staining is referred to as “COX-negative muscle fibers.”  The paracrystalline inclusions seen on EM are also known as “parking lot” inclusions.


Of possible interest:

Your cells coordinate two genomes: nuclear DNA which follows Mendelian inheritance, and mitochondrial DNA (mtDNA) which does not follow Mendelian inheritance (I would suggest reading about homoplasmy, heteroplasmy, threshold, mtDNA copy number, variable dependence of different cells on mitochondrial energy production).

Your mitochondria are inherited from your mother.

Chloroplasts in plants also retain their own genomes.


Reference(s) / additional reading:

Fernandez-Vizarra E, Zeviani M. Mitochondrial disorders of the OXPHOS system. FEBS Lett. 2021 Apr;595(8):1062-1106. doi: 10.1002/1873-3468.13995. Epub 2020 Dec 18. PMID: 33159691.

Filograna R, Mennuni M, Alsina D, Larsson NG. Mitochondrial DNA copy number in human disease: the more the better? FEBS Lett. 2021 Apr;595(8):976-1002. doi: 10.1002/1873-3468.14021. Epub 2020 Dec 25. PMID: 33314045; PMCID: PMC8247411.

Russell OM, Gorman GS, Lightowlers RN, Turnbull DM. Mitochondrial Diseases: Hope for the Future. Cell. 2020 Apr 2;181(1):168-188. doi: 10.1016/j.cell.2020.02.051. Epub 2020 Mar 26. PMID: 32220313.

Rahman S. Mitochondrial disease in children. J Intern Med. 2020 Jun;287(6):609-633. doi: 10.1111/joim.13054. Epub 2020 Apr 7. PMID: 32176382.


Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.