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Lymphocytic active myocarditis characterized by numerous clusters of lymphocytes: a chronic variant of myocarditis?
M Okabe1, K Fukuda, Y Nakashima
1Department of Internal Medicine, Fukuoka University, School of Medicine, Japan.
Insights
This study describes a specific type of myocarditis, termed chronic active myocarditis, affecting three patients. This condition led to progressive heart failure over several years, characterized by lymphocytic clusters and fibrosis.
Area of Science:
- Cardiology
- Pathology
Background:
- Myocarditis is an inflammatory condition of the heart muscle.
- Understanding distinct subtypes of myocarditis is crucial for diagnosis and treatment.
Observation:
- Three patients presented with a unique form of myocarditis.
- Histological examination revealed numerous lymphocytic clusters and myocardial damage.
- Clinical course involved progressive, fatal heart failure over 3-6 years.
Findings:
- The observed myocarditis featured extensive fibrosis and acute myocardial cell damage.
- Cardiac autopsy revealed dilated ventricles and atria with mural thrombi.
- Conduction disturbances were noted in two patients.
Implications:
- The proposed term 'chronic active myocarditis' captures the distinct clinicopathologic features.
- This classification may aid in recognizing and managing this specific heart condition.
- Further research into the etiology and treatment of chronic active myocarditis is warranted.
Abstract:
We report three patients with a particular form of myocarditis characterized by numerous clusters of lymphocytes. Their common clinical manifestation was progressive and fatal heart failure with a 3- to 6-year duration. Atrioventricular and intraventricular conduction disturbances were observed in two patients. At necropsy, the hearts weighed 480, 530, and 430 gm, respectively, and showed marked dilatation of the bilateral ventricles and atria, with frequent mural thrombi. Histologic examination revealed numerous lymphocytic clusters and scattered foci of acute myocardial cell damage on a background of extensive fibrosis. We propose the term "chronic active myocarditis" to denote clinicopathologic characteristics of the present cases.