Singh Ahongshangbam Meina, Debnath Kaushik, Devi Soibam Subadani, Devi Pukhrambam Gayatri, Konjengbam Ratan, Nabachandra Huidrom
Department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
Indian J Chest Dis Allied Sci. 2003 Jul-Sep;45(3):195-8.
We present a case of a 28-year-old male weight lifter who died suddenly while driving a bicycle. Forensic autopsy and histopathological examinations revealed granulomatous lesions in the myocardium and hilar lymph nodes. The latter had massive caseation necrosis, epithelioid granulomas and Langhans' giant cells suggestive of tuberculosis. However, the myocardium showed predominantly multinucleated foreign body and myogenic giant cells, lymphocytes, plasma cells, macrophages, eosinophils. Staining for acid-fast bacilli was negative. The present case highlights the difficulty in establishing whether the granulomatous lesions in the hilar lymph nodes and the myocardium are incidental findings or whether they are related by the same pathogenetic mechanisms.
我们报告一例28岁男性举重运动员在骑自行车时突然死亡的病例。法医尸检和组织病理学检查显示心肌和肺门淋巴结有肉芽肿性病变。后者有大量干酪样坏死、上皮样肉芽肿和朗汉斯巨细胞，提示为结核病。然而，心肌主要表现为多核异物巨细胞、肌源性巨细胞、淋巴细胞、浆细胞、巨噬细胞、嗜酸性粒细胞。抗酸杆菌染色为阴性。本病例凸显了确定肺门淋巴结和心肌中的肉芽肿性病变是偶然发现还是由相同的发病机制相关联的困难。
