Abstract
Aim – detection of lipomatosis of different intensity and preoperative epi- and myocarditis.
Material and methods. 158 autopsies patients (88 men, 67 women aged 22–84 years and 21–85 years), respectively, undergoing heart, coronary and main vessel surgery were examined. The material was fixed in 10% neutral formalin and poured into paraffin. Sections 4–6 μm thick were stained with hematoxylin and eosin, in one observation using the immuno-peroxidase method, expression of vimentin, CD68 and Ki67 was revealed.
Results. Right ventricular (RV) myocardial lipomatosis significantly varied from case to case and was practically absent in 22 (13.9%) observations, the minimum degree of lipomatosis was noted in 44 cases (27.9% autopsies), the average in 56 cases (35.5% autopsies) and sharply expressed in 36 cases (22.8% autopsies). In 13 (8.2%) observations left ventricular lipomatosis occurred. The most pronounced fat infiltration of myocardial interstition in most observations occurred in the outlet and anterior walls of the RV. Productive preoperative epicarditis was detected in 33 observations, while in 20 observations lymphohistyocytic infiltration of different severity was noted, with coupling-shaped histiocytic infiltrates in 7 cases (in all these cases there was pronounced lipomatosis of the RV myocardium with preferential localization in its outlet region and anterior wall), preferential lymphocytic infiltration epimyocardium developed in 5 cases, it was shown by primary lymphocytic infiltration in 1 case, lympho-histyocytic infiltration in 3 cases and primary histyocytic infiltration with formation of "clutch" in 1 case, the detailed description of this unique observation of the histyocytic/macrophagal epicarditis and subepicardial myocarditis is provided.
Conclusion. The patho- and morphogenesis of productive epicarditis and epimiocarditis depends on the severity of epicardial fat and the nature of myocardial lipomatosis, preferential histiocytic/macrophagal infiltration of these parts of the heart is observed at its maximum development.
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About the authors
- Roman A. Serov, Dr. Med. Sci., Professor, Head of Department; ORCID
- Elena A. Pomazanova, Junior Researcher, Physician-Pathologist; ORCID
- Margarita V. Gordeeva, Cand. Med. Sci., Senior Researcher; ORCID
- Anna E. Zharikova, Junior Researcher, Physician-Pathologist; ORCID
- Elena V. Penyaeva, Senior Researcher, Physician-Pathologist; ORCID
- David R. Tevosov, Junior Researcher, Physician-Pathologist; ORCID
- Georgiy A. Khugaev, Cand. Med. Sci., Junior Researcher, Physician-Pathologist; ORCID
- Boris N. Bogonatov, Cand. Med. Sci., Physician-Pathologist
- Natal’ya A. Tret’yakova, Physician-Pathologist
