Intracardiac giant cells after left ventricular assist device placement

Multinucleated giant cells are seen in the heart in several distinct pathologic conditions, including giant cell myocarditis, sarcoidosis and infectious etiologies. We describe the first report of solitary multinucleated giant cells scattered throughout the heart after placement of a left ventricular assist device (LVAD) and transient Candida glabrata infection. The pathologic findings were noted in the explanted heart of a patient undergoing orthotopic cardiac transplantation 7 months after LVAD surgery. The presence of solitary giant cells without adjacent inflammation was a distinct histologic finding in this case. An awareness of this entity is important to avoid making a diagnosis of a more severe giant cell-related pathologic disease, which may recur in a transplanted heart.