Gori F, Taddei G L, Pedemonte E, Ciaccheri M
Istituto di Anatomia ed Istologia Patologica, Università degli Studi, Firenze.
Cardiologia. 1997 Apr;42(4):421-3.
We present a case of predominantly myocardial sarcoidosis in a 38 year-old man. A second degree atrioventricular block was the clinical presentation, followed 2 years later by sudden cardiac arrest. Autopsy revealed large areas of myocardial scarring in the left ventricular wall unassociated with atherosclerotic coronary lesions; microscopy of these areas disclosed epithelioid granuloma with giant cells embedded in a fibrohyaline tissue. The insidious cardiac involvement in sarcoidosis often hinders an exact diagnosis in life, and prognosis without therapy is severe. Histopathologic diagnosis is made only by exclusion of other systemic granulomatous diseases.
我们报告一例38岁男性以心肌结节病为主的病例。二度房室传导阻滞为临床表现，2年后发生心脏骤停。尸检发现左心室壁有大面积心肌瘢痕形成，与动脉粥样硬化性冠状动脉病变无关；这些区域的显微镜检查显示上皮样肉芽肿，巨细胞嵌入纤维透明组织中。结节病隐匿性心脏受累常阻碍生前准确诊断，未经治疗预后严重。组织病理学诊断只能通过排除其他系统性肉芽肿性疾病来做出。
