[Myocardial sarcoidosis--pathological studies on 7 autopsy cases with particular reference to histological...

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.