IGCM (Idiopathic giant cell myocarditis)
General: Severe and rapidly fatal (median ~5.5 months to transplant or death), affecting relatively young otherwise healthy adults. Present with congestive heart failure. Has been non-specifically associated with autoimmune disorders including inflammatory bowel disease, hyperthyroidism, and hypothyroidism. May recur in a transplanted heart despite aggressive immunosuppression.
Gross:
Microscopic: Diffuse geographic myocardial necrosis with mixed inflammation including lymphocytes, histiocytes, and eosinophils, as well as characteristic multinucleated giant cells without granulomas.
Differential Diagnosis:
Stains:
- Positive:
- Negative:
- Suggested, focused panel:
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Images:
Cases:
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