|
The pathologist
should comment on the following features in the histopathology report
:
Changes in the endocardium:
- Inflammation :
Type and severity of the
inflammation: chronic
non-specific - viral myocarditis; granulomatous - sarcoidosis,
severity- comparison with previous biopsies. Sequential biopsies are taken to compare the severity and extent of the inflammation with
the previous biopsy .
-Fibrosis
and elastosis : pattern
and extent
-Presence of
mural thrombus
:
-Presence of
foreign material such as from
intravenous substance abuse.
Changes in the myofibres:
-
Variation in size
(measured quantitatively if appropriate);
- Nuclei:
Pleomorphism ; Presence of
bizarre forms especially in hypertrophy;
- Disarray: when widespread and in the
appropriate clinical setting, this
suggests hypertrophic cardiomyopathy.
- Degeneration:
Vacuolation ; Basophilia ;
Myocytolysis;
- Necrosis:
- Depositions:
Lipofuscin ; Haemosiderin ;
Calcium ; Crystals such as
oxalate.
Changes in the
interstitium:
- Type of inflammation :
Chronic non-specific ; granulomatous ;
Giant cell (sarcoid and idiopathic giant cell myocarditis) ;
Eosinophilic(endomyocardial fibroelastosis , parasitic infections) ;
Histiocytic ; Aschoff
nodules (rheumatic fever) ;
- Severity :
comparison with previous biopsies if
necessary;
- Oedema:
- Fibrosis :
distribution and extent;
- Depositions :
Haemosiderin ; Calcium ; Crystals such as oxalate ; Amyloid .
|
