Rheumatic heart disease
Jump to navigation
Jump to search
The printable version is no longer supported and may have rendering errors. Please update your browser bookmarks and please use the default browser print function instead.
Rheumatic heart disease, abbreviated RHD, is a relatively uncommon heart valve pathology that follows rheumatic fever.
General
- Classically leads to mitral valve stenosis.
- Disease less frequent today - as streptococcal pharynigits is treated with antibiotics.
Gross
- "Fish-mouth appearance".
- Slit-like morphology; elliptical cross-sectional flow area (mitral valve) has an abnormally small semi-minor axis[3] axis due to valve thickening.
- Image: Fish-mouth appearance - pipe (principia-eng.com).
- Significant valvular thickening.
- Thickening and shortening of the cordae tendinae.
DDx:
Images
Microscopic
Features:[5]
- Caterpillar cells (AKA Anitschkow cells)
- Abundant eosinophilic cytoplasm.
- Moderately-poorly defined cell border.
- Well-defined central ovoid nucleus with a prominent wavy ribbon-like chromatin -- looks vaguely like a caterpillar with some imagination.
- Pathognomonic for rheumatic fever.
- Aschoff bodies - usually in the heart itself:
- Jumbled collagen, eosinophilic.
- Surrounded by lymphocytes (T cells) +/- plasma cells.
Notes:
- Anitschkow cells are thought to be histocytes and Aschoff bodies are thought to be granulomas.[6]
- This is disputed.[7]
Images
IHC
Features (Aschoff bodies & Anitschkow cells):[6]
- S100 -ve.
- Muscle specific actin -ve.
- Desmin -ve.
- NF -ve.
- Vimentin +ve.
- CD45 +ve (weak).
See also
References
- ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 594. ISBN 0-7216-0187-1.
- ↑ Chopra, P.; Gulwani, H. (Oct 2007). "Pathology and pathogenesis of rheumatic heart disease.". Indian J Pathol Microbiol 50 (4): 685-97. PMID 18306530.
- ↑ URL: http://en.wikipedia.org/wiki/Ellipse. Accessed on: 13 November 2010.
- ↑ Rose, Alan G. (2008). Atlas of Gross Pathology with Histologic Correlation (1st ed.). Cambridge University Press. pp. 25. ISBN 978-0521868792.
- ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 593. ISBN 0-7216-0187-1.
- ↑ 6.0 6.1 Love, GL.; Restrepo, C. (Jul 1988). "Aschoff bodies of rheumatic carditis are granulomatous lesions of histiocytic origin.". Mod Pathol 1 (4): 256-61. PMID 3070554.
- ↑ Stehbens, WE.; Zuccollo, JM. (May 1999). "Anitschkow myocytes or cardiac histiocytes in human hearts.". Pathology 31 (2): 98-101. PMID 10399163.