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                      September  2006  Case - 93

                                              Dr  Sampurna Roy  MD 

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      Clinical History: A 45 year old woman died of congestive heart failure.

        At autopsy, her heart was slightly enlarged and the heart muscle was thickened with many

        small whitish nodules.

                                                          

                                             

Note:   Granulomatous Inflammation of the Heart :   Reference: click here

- Diseases showing well-developed granulomas : Disease caused by infective agents (tuberculosis, fungal and parasitic disorders ) ;  Sarcoidosis  ;  Giant cell myocarditis ;  A reaction to foreign bodies and devices implanted within the cardiovascular system.

- Rheumatic Fever : Specific lesion characterized by granulomas known as Aschoff's nodules.

- Metabolic disorders :  Granulomas occur in Farber's disease (lipogranulomatosis)  ; Gout (in which tophi are associated with calcific deposits and with a foreign body cellular reaction)  ;  Various syndromes of oxalosis (in which oxalate deposits also lead to a foreign body reaction)  ;  In chronic granulomatous disease of childhood.

- Other conditions showing Foreign body giant cells :  In association with calcification of necrotic myocytes and in the syndromes of "cholesterol pericarditis".

                      What is the diagnosis of Case No 93 ?

                                                               DIAGNOSIS:

 

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