Lymphocytic myocarditis


The findings suggest myocarditis, 2 criteria of Lake Louise consensus, includes T2 myocardium to skeletal muscle signal ratio > 1.9 and delayed myocardial enhancement including sub-epicardial and mid myocardium. The course of the disease was so aggressive that the patient passed away few weeks after the exam. 

Gross Description:  

The specimen is received on saline soaked gauze in a container labeled with   the patient's name and "myocardial biopsy x6" and consists of six fragments of   tan-pink soft tissues ranging from 0.1-0.25 cm in greatest dimension. The  specimen is submitted in toto in one cassette. Please note some of the tissues may not survive processing.

Microscopic Description:  

Histologic evaluation reveals fragments of myocardium with chronic   inflammation including lymphocytes and rare eosinophils.  Rare giant cells are   present.  A Congo red stain is negative for amyloid. Fragments of myocardium are moderately fibrotic and contain a patchy moderately dense chronic inflammatory cell infiltrate comprised predominantly of lymphocytes with a few plasma cells and an occasional eosinophil.