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21st European Congress of Pathology
Istanbul, Turkey, September 08-13, 2007
http://www.ecp2007istanbul.org/
Slide Seminar 2, September 11th
The Surgical Pathology of Cardiovascular Disease
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Case 1
Presented by: Dr. Ian Cook
Clinical History
Female, 53-year-old. Left neck mass. Brown gray nodule weighing 22 g,48x35x28mm. Nodular Brown cut surface with area of haemorrhage. Two overlying lymph nodes measuring 22mm and 25mm, uniform cut surfaces.
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Diagnosis & discussion |
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Case 2
Presented by: Dr. Ian Cook
Clinical History
Male, 45-year-old. Slowly growing erythematous lesion on sole of right foot.
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Diagnosis & discussion |
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Case 3
Presented by: Dr. Loirne B. Meijer-Jorna
Clinical History
Boy, 5-year-old, who had a blue reddish discolouration on his left leg, 22cm with a venous sign. The lesion was present since his birth and showed no involution. Once in a while he complained about pain. MRI scan revealed a well dimnished lesion with a lobed aspect in dermis and subcuis. It was clinically a low flow lesion.
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Diagnosis & discussion |
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Case 4
Presented by: Dr. Lorine B. Meijer-Lorna
Clinical History
A biopsy of the superficial temporal artery was taken from 67-year-old woman who suffered from a general feeling of malaise, with laboratory signs of anemia, leucocytosis and thrombocytosis.
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Diagnosis & discussion |
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Case 5
Presented by: Dr. Heike Göbel
Clinical History
A 37-year-old female patient, presented with a rapid onset of myocardial failure requiring heart transplantation. An ischemic origin was ruled out and another reason was estimated by the clinicians.
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Diagnosis & discussion |
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Case 6
Presented by: Dr. Helen Doran
Clinical History
A 74-year-old woman with large bilobed, smooth tumour in the left atrium arising from the left inferior pulmonary vein orifice. Past history of leiomyosarcoma of the uterus with hysterectomy 2 years earlier.
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Diagnosis & discussion |
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Case 7
Presented by: Prof. P Bruneval
Clinical History
A 42-year-old male patient was transferred to the university hospital for endomyocardial
biopsy. This heavy smoker had heart palpitation for 1 year. He presented with shortness of breath at effort for 3 months and was referred to a cardiologist. At this time, main findings were: supraventricular tachycardia and right branch bundleblock at ECG, normal urine and blood biology ( including thyroid hormones) except for a mild hypogammaglobulinemia, left ventricle hypertrophy and hypocontractility without dilatation at transesophageal echo and at RMI. Echo and RMI patterns of the left ventricle myocardium were suggestive of amyloidosis. However, a labial salivary gland biopsy stained with Congo red was negative. At the university hospital, a coronary angiogarphy showed normal coronary arteries. During this procedure, a left ventricle endomyocardial biopsy was performed and is presented here. Arrhythmia treatment required a pace-maker implantation 1month later. Cardiac failure rapidly worsened and 3 months later after a brief emergency extracorporeal assist device, a cardiac transplantation was performed.
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Diagnosis & discussion |
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Case 8
Presented by: Dr. Rosa Henriques de Gouveia
Clinical History
The case hereby presented corresponds to an 18-year-old white male who seek medical care due to fever, chest pain ( radiating to the back) and tiredness for 10 days. During clinical investigation an echocardiogram was performed, revealing a ‘’mass’’ inside the left atrium, that raised the suspicion of a myxoma. He had antecedens of tonsilectomy , appendectomy and excision of a pleomorphic adenoma of the parotid gland. His father had recently died of lung cancer. The patient was transferred to the Cardiothoracic Surgery Department for surgical removal of the tumour, where a tansesophagic echocardiogram better characterized its connection to the interatrial septum by a stalk.
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Diagnosis & discussion |
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Case 9
Presented by: Prof. Annalisa Angelini
Clinical History
Polyarthralgia in an 81-year-old lady. She was admitted to the hospital because of gangrenous lesion of the left hand fingers and eritromelalgia and ischemc lesions of the right hand. Since angiography showed stenotic lesions of the brachicephalic arteries with occlusion of the right internal carotid artery she underwent surgical revascularization. Past history: intracranial hemorrhage, and more recently asthenia, polymialgies and arthritis. Macroscopic examination: segment of omental artery with a whitish occlusion.
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Diagnosis & discussion |
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Case 10
Presented by: Prof. Annalisa Angelini
Clinical History
A 59-year-old man was admitted to the hospital with a recent onset of dyspnea and previous history of arrythmias. Hemodynamic study showed normal coronary arteries and a hypertrophic left ventricle with infero-basal and lateral akynesia and severe mitral vale insufficiency. An endomyocardial biopsy was performed.
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Diagnosis & discussion |
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Case 11
Presented by: Prof. Anton Lehr
Clinical History
The patient , a 55- year-old Caucasian lady with no previous medical history, collapsed when driving home in her car after a leisurely swimming session. She had sufficient time prior to cardiopulmonary resuscitation to report to a bystander of a recent history (one week prior) of chest pain but for which she had not consulted a physician. Cardio-respiratory reanimation was peormed for 40 minutes, but without success. At autopsy, no Marfan or Danlos syndrome was noted , the heart weighed 310 grams ( body weight 55 kilogram, height165 cm, body mass index 20,2). No vascular or myocardial abnormalities were noted. No cardiac hypotrophy ( LV 1,3 cm, RV 0,5cm). The ascending aorta was macroscopically normal. Examination of the coronary tree revealed no atherosclerotic changes but rather complete occlusion of all tree main coronary arteries. H&E slides contains cross section of coronary artery.
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Diagnosis & discussion |
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