5 thoughts on “an adult cardiac pathology case for opinions please”

  1. claerly patchy resolving inflammation and fibrosis
    atypical nuclei are suggestive of viral effects…but not specific
    assuming no cardiotoxins may be worth em/ PCR

  2. I agree with the proposed cause of death. Interesting that it looks like it is in the resolving phase. PCR for viral studies on the tissue blocks would be worth a go. My question was going to be about the nuclear changes especially in the 7th image, but it would fit together if they are likely viral changes.

  3. Thanks both for your comments!
    I have mentioned the possibility of PCR to the referring Pathologist (no known cardiotoxins ).

  4. Don’t think they look like viral inclusions, but may be proven wrong with the PCR. If this is all viral, then has been going on for some time with mature fibrosis as well as recent myocyte loss. The inflammation seems to be more part of granulation tissue, can’t see anything convincing that it is the cause of the myocyte loss.

  5. I agree with Kim that EM might be informative. Might the inclusions in 11/16 be intracytoplasmic? we have had a case of storage disease (Danon disease) for transplant which was genetically confirmed but the vacuolated myocytes were very patchy and most of the changes fibrotic.

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