Figure 1: Pathologic findings in quadriceps muscle biopsy. (a) NADH stain. Chronic myopathic changes with fiber size variation and myofibrillar alterations, including many lobulated fibers (arrows). (b) Gömöri trichrome stain. Many dark staining nemaline rods are seen in a highly atrophic fiber (black arrow) and aggregated beneath the sarcolemma (white arrows) and scattered in sarcoplasm in these adjacent myofibers.