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尸检中的心肌炎

Myocarditis in autopsy.

作者信息

Okada R, Wakafuji S

出版信息

Heart Vessels Suppl. 1985;1:23-9. doi: 10.1007/BF02072354.

Abstract

In the Annuals of Autopsy Records for Japan from 1958 to 1977, 377,841 autopsy cases were registered; a short summary of pathologic findings was included. Of the 377,841 cases, 409 (0.11%) were registered as idiopathic, nonspecific, interstitial, or viral myocarditis and 25 cases (0.007%) as giant-cell myocarditis. The annual incidence of the myocarditis varied at 5-year intervals and a remarkable increase was observed after 1974. An analysis of 19 cases of myocarditis and 19 of postmyocarditic cardiomegaly (PMC) showed a preponderance of males. Dilatation of ventricles was found in all cases of acute, subacute, and healing myocarditis, which histologically showed interstitial mononuclear cell infiltration, necrosis, and disarray of myocytes. Hypertrophy with ventricular dilatation, ventricular dilatation without hypertrophy, endo- or epicardial involvement, and right ventricular lipomatosis were found in 70%, 20%, 30%, and 10% of cases with chronic myocarditis and PMC, respectively. In these cases, residual inflammation, fibrosis, and hypertrophy was observed histologically.

摘要

在1958年至1977年的日本尸检记录年鉴中,登记了377,841例尸检病例,并包含了病理检查结果的简要总结。在这377,841例病例中,有409例(0.11%)被登记为特发性、非特异性、间质性或病毒性心肌炎,25例(0.007%)为巨细胞性心肌炎。心肌炎的年发病率每隔5年有所变化,1974年后观察到显著上升。对19例心肌炎病例和19例心肌炎后心脏扩大(PMC)病例的分析显示男性占多数。在所有急性、亚急性和愈合期心肌炎病例中均发现心室扩张,组织学表现为间质单核细胞浸润、坏死和心肌细胞排列紊乱。在慢性心肌炎和PMC病例中,分别有70%、20%、30%和10%的病例出现伴有心室扩张的肥厚、无肥厚的心室扩张、心内膜或心外膜受累以及右心室脂肪瘤。在这些病例中,组织学观察到残留炎症、纤维化和肥厚。

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