Imai M, Takeishi M, Toyoda C, Kaneda Y
Acta Pathol Jpn. 1975 Jul;25(4):477-97.
The present report consists of seven autopsy cases of myocardial sarcoidosis terminating in death 1 month to 5 years after the onset of symptoms. Histologically, they were classified into the following 4 types: a) diffuse nonspecific granulation, b) specific granuloma with giant cells, c) diffuse fibrosis with giant cells, and d) nonspecific fibrosis. Types a) and b) demonstrate active changes, while c) and d) are sequelae of active inflammation. Morphological changes of sarcoidosis were found not only in myocardium but also in both pericardium and endocardium. Although no final conclusions could be obtained as to whether the giant cells appearing in myocardium were of mesenchymal or myogenic origin, the authors favor the latter concept. Changes compatible to sarcoidosis found in other organs in acute cases were scarce and old. On the contrary, more active and variable changes were encountered in protracted cases. The authors consider giant cell myocarditis to be one type of sarcoidosis occurring in the heart.
本报告包括7例心肌结节病尸检病例,这些病例在症状出现后1个月至5年死亡。组织学上,它们被分为以下4种类型:a)弥漫性非特异性肉芽组织,b)伴有巨细胞的特异性肉芽肿,c)伴有巨细胞的弥漫性纤维化,d)非特异性纤维化。a型和b型表现为活动性改变,而c型和d型是活动性炎症的后遗症。结节病的形态学改变不仅见于心肌,也见于心包和心内膜。尽管对于心肌中出现的巨细胞是间充质起源还是肌源性起源无法得出最终结论,但作者倾向于后一种观点。急性病例中在其他器官发现的与结节病相符的改变很少且陈旧。相反,在迁延性病例中遇到的改变更活跃且多样。作者认为巨细胞性心肌炎是发生在心脏的结节病的一种类型。