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Inflammatory heart diseases. Fiedler intersti tial my ocardit is From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi. Fig.16.1. Fig.16.1-2. Fiedler intersti tial my ocardit is My ocardit is of unknown etiology and cause of SCD with CF in children
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Fiedlerinterstitial myocarditisFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi Fig.16.1
Fig.16.1-2. Fiedlerinterstitial myocarditis • Myocarditis of unknown etiology and cause of SCD with CF in children • Diffuse interstitial inflammatory infiltrate composed of neutrophiles, lymphocytes, macrophages and multinucleated giant cells • Extensive myocyte necrosis Fig.16.2
Viralinterstitial myocarditisFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi Fig.16.3
Fig.16.3-4 Viral myocarditis • Interstitial mononuclear inflammatory infiltrate and variable diffuse interstitial edema • Myocardial fibers with degenerative lesions that range from minimal to moderate; focal myocite necrosis. Fig.16.4
Rheumatic myocarditisFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi Fig.16.5. Aschoff granuloma
Fig.16.6. Rheumatic myocarditis • Aschoff granuloma: micronodular lesion located in the myocardial connective interstitium with paravascular disposition • Aschoff granuloma is composed of: • Central area of fibrinoid necrosis • Aschoff cells: large cells, bazophilic cytoplasm, and 1 or 2 nuclei • Anicikov cells: fusiform cells with irregular nuclei, looking as caterpillar • Macrophages, lymphocytes, and plasma cells, fibroblasts
Rheumatic mitral and aortic stenosisFrom: Stevens A. J Lowe J. Pathology. Mosby 1995 Macroscopically, mitral valves are thickened, hard, with fused comissures, defining a small, round or slit-like orifice looking as a mouth-fish. In AS, aortic cusps are thickened by fibrosis, comissures are fused, and aortic oriffice is narrowed. Fig.16.7.
Fig.16.8 EISA VS EIAvegetativeE. vs ulcero-vegetative E.
Subacute infectious endocarditis-(vegetant endocarditis) - EISAFrom: Stevens A. J Lowe J. Pathology. Mosby 1995 Fig.16.9 Fig.16.9. Macroscopy: multiple, polypoid, gray-reddish and friable vegetations, arranged in bouquet on the mitral valve surfaces, and small vegetations grouped on adjacent parietal endocardium, too. Usually, they don’t produce valvular damages: rupture or perforation.
Acute infectious endocarditis-(ulcerovegetant endocarditis) - EIA Fig.16.10 Fig.16.10. Macroscopy: bulky, gray-reddish, friable, vegetations located on the surface of aortic sigmoid valves and parietal endocardium. By perforation, ulceration and rupture of valves, results valvular incompetence and acute heart failure