Difference between revisions of "Heart"
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| − | + | {{Comprehensiveness}} | |
{{Fixation - standard}} | {{Fixation - standard}} | ||
{{Fixation - general notes}} | {{Fixation - general notes}} | ||
==Presentations== | ==Presentations== | ||
| − | *[[Heart autopsy]] | + | *'''[[Heart autopsy]]''' |
:*[[Autopsy of myocardial infarction]] | :*[[Autopsy of myocardial infarction]] | ||
| + | *'''[[Heart valve]]''' | ||
| + | |||
| + | ==Gross processing== | ||
| + | Heart specimens are generally not [[ink]]ed. | ||
==Basic microscopic screening== | ==Basic microscopic screening== | ||
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{{Further|Autopsy of myocardial infarction}} | {{Further|Autopsy of myocardial infarction}} | ||
| − | ==Common findings== | + | {{Moderate-begin}}For myocardial biopsies: |
| − | <gallery> | + | *Evaluate specimen adequacy. An adequate amount of tissue is generally 4 fragments (or 3 if each fragment is high quality). |
| − | File:Myocardial lipofuscin (annotated).jpg|Myocardial '''lipofuscin''' reflects normal ageing rather than any cardiac pathology | + | *Evaluate on H&E, trichome stain (to better evaluate any fibrosis) and Congo red (to exclude any amyloid).{{Moderate-end}} |
| + | |||
| + | ===Common findings=== | ||
| + | <gallery mode=packed heights=150> | ||
| + | File:Myocardial lipofuscin (annotated).jpg|Myocardial '''lipofuscin''' reflects normal ageing rather than any cardiac pathology,<ref name="KakimotoOkada2019">{{cite journal|last1=Kakimoto|first1=Yu|last2=Okada|first2=Chisa|last3=Kawabe|first3=Noboru|last4=Sasaki|first4=Ayumi|last5=Tsukamoto|first5=Hideo|last6=Nagao|first6=Ryoko|last7=Osawa|first7=Motoki|title=Myocardial lipofuscin accumulation in ageing and sudden cardiac death|journal=Scientific Reports|volume=9|issue=1|year=2019|issn=2045-2322|doi=10.1038/s41598-019-40250-0}}</ref> and does not need mentioning in the elderly. | ||
File:Histopathology of ruptured intercalated discs.jpg|Ruptured intercalated discs. {{Further|Ruptured intercalated discs|linebreak=no}} | File:Histopathology of ruptured intercalated discs.jpg|Ruptured intercalated discs. {{Further|Ruptured intercalated discs|linebreak=no}} | ||
File:Histopathology of dense fibrous scar replacing myocyte loss in myocardial infarction.jpg|'''Fibrosis'''. {{further|Myocardial fibrosis|linebreak=no}} | File:Histopathology of dense fibrous scar replacing myocyte loss in myocardial infarction.jpg|'''Fibrosis'''. {{further|Myocardial fibrosis|linebreak=no}} | ||
| + | File:Histopathology of myocardial hypertrophy.jpg|Myocardial '''hypertrophy''' (in right image, compared to normal at left). | ||
| + | File:Histopathology of moderate myocardial hypertrophy - boxcar nuclei.jpg|Rectangular "'''Boxcar'''" nuclei: Look for myocardial hypertrophy, especially when enlarged. Otherwise, [[ruptured intercalated discs]] can cause square shaped nuclei. | ||
| + | </gallery> | ||
| + | ===Other conditions to look for=== | ||
| + | <gallery mode=packed heights=150> | ||
| + | File:Histopathology of giant-cell myocarditis.jpg|'''Giant-cell myocarditis''', with multinucleated giant cells. | ||
| + | File:Histopathology of lymphocytic myocarditis with myocyte necrosis, annotated.jpg|'''Lymphocytic myocarditis''' (white arrow points to a lymphocyte), commonly showing myocyte necrosis (black arrow), seen as hypereosinophilic cytoplasm with loss of striations. | ||
</gallery> | </gallery> | ||
{{Bottom}} | {{Bottom}} | ||
Latest revision as of 12:44, 22 January 2024
Author:
Mikael Häggström [note 1]
Contents
Comprehensiveness
On this resource, the following formatting is used for comprehensiveness:
- Minimal depth
- (Moderate depth)
- ((Comprehensive))
Fixation
Generally 10% neutral buffered formalin.
See also: General notes on fixation
Presentations
Gross processing
Heart specimens are generally not inked.
Basic microscopic screening
Generally check for signs of myocardial infarction. Further information: Autopsy of myocardial infarction
(For myocardial biopsies:
- Evaluate specimen adequacy. An adequate amount of tissue is generally 4 fragments (or 3 if each fragment is high quality).
- Evaluate on H&E, trichome stain (to better evaluate any fibrosis) and Congo red (to exclude any amyloid).)
Common findings
Myocardial lipofuscin reflects normal ageing rather than any cardiac pathology,[1] and does not need mentioning in the elderly.
Ruptured intercalated discs. Further information: Ruptured intercalated discs
Fibrosis. Further information: Myocardial fibrosis
Myocardial hypertrophy (in right image, compared to normal at left).
Rectangular "Boxcar" nuclei: Look for myocardial hypertrophy, especially when enlarged. Otherwise, ruptured intercalated discs can cause square shaped nuclei.
.jpg)
Other conditions to look for
Giant-cell myocarditis, with multinucleated giant cells.
Lymphocytic myocarditis (white arrow points to a lymphocyte), commonly showing myocyte necrosis (black arrow), seen as hypereosinophilic cytoplasm with loss of striations.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
Image sources
