Pericardium

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Pericardium is a specimen that uncommonly comes to pathology.

The heart wall (schematic). (WC/Wikiversity Journal of Medicine)

Pathologies of the pericardium

Benign

  • Idiopathic pericarditis - common.[1]
  • Infectious pericarditis - post-procedural.
  • Fibrinous pericarditis.
  • Pericardial cyst.
    • Rare - 1 in 100,000.[2]
    • Typical location: right cardiophrenic angle.[2]

Malignant

Related pathologies

  • Pericardial effusion.
  • Hemopericardium.
  • Cardiac tamponade.

Specific entities

Idiopathic pericarditis

Pericarditis redirects here.

General

  • Uncommon.
  • In the clinical context pericarditis is used for things that probably don't have inflammation.[3]
    • "Pericardial heart disease" may be a better descriptor.

Etiologies of pericarditis:[2]

Gross

Features:[2]

Notes:

  • Normal pericardial fluid volume 5-35 mL.[2]

Microscopic

Features:

  • Inflammatory cells:
    • Neutrophils.
    • Lymphocytes.
    • Plasma cells.
  • +/-Hemosiderin-laden macrophages.

DDx:

Images

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PERICARDIUM, BIOPSY:
- ACUTE AND CHRONIC PERICARDITIS WITH SIDEROPHAGES AND REACTIVE MESOTHELIAL CHANGES.
- NO MICRO-ORGANISMS SEEN WITH ROUTINE STAINING.
- NO EVIDENCE OF MALIGNANCY.

Micro

The sections show fibrous tissue with minimal adipose tissue that is covered by mesothelium. A mixed inflammatory infiltrate is present that consists primarily of lymphocytes and plasma cells. Rare eosinophils are seen. Focally, neutrophils are seen and associated with reactive mesothelial cells. Abundant hemosideratin-laden macrophages are seen. No fibrinous strands are seen. No significant nuclear atypia is identified and no atypical infiltrative cell population is identified. No micro-organisms are identified with routine staining.

See also

References

  1. 1.0 1.1 Smets P, Guettrot-Imbert G, Hermet M, et al. (September 2013). "[Recurrent pericarditis related to primary pericardial malignant mesothelioma]" (in French). Rev Med Interne 34 (9): 573–6. doi:10.1016/j.revmed.2013.04.021. PMID 23773902.
  2. 2.0 2.1 2.2 2.3 2.4 Peebles CR, Shambrook JS, Harden SP (December 2011). "Pericardial disease--anatomy and function". Br J Radiol 84 Spec No 3: S324–37. doi:10.1259/bjr/16168253. PMC 3473919. PMID 22723538. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473919/.
  3. Roberts, WC. (Jan 2005). "Pericardial heart disease: its morphologic features and its causes.". Proc (Bayl Univ Med Cent) 18 (1): 38-55. PMID 16200146.