Document Detail


Concomitant intramyocardial and epicardial vasculitis in an autopsied heart allograft for cardiac rhabdomyosarcoma.
MedLine Citation:
PMID:  12437628     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Primary cardiac tumours are rare, with only one quarter of the patients being malignant. The vast majority of malignant neoplasms of the heart are sarcomas. We describe a patient of primary cardiac rhabdomyosarcoma presented as coronary artery disease and recurrent myocardial infarction. Histopathologic finding of the excised native heart revealed a high grade pleomorphic rhabdomyosarcoma in the myoepicardial portion of the anterior wall with rupture. The accompanying unusual feature was myocardial infarction because of tumour emboli of the left anterior descending and left circumflex coronary arteries. After transplantation, the patient developed mild to moderate acute cellular rejection of the transplanted heart on post-transplantation day 1, 8, and 44, respectively. Unfortunately, he expired on the post-transplantation day 47 because of acute rejection, presenting as concomitant intramyocardial and epicardial lymphocytic vasculitis and multifocal myocardial ischaemia. We found that this uncommon medial lymphocytic vasculitis lesion was mediated by T cells and also by antibody directly against smooth muscle cells of small arteries. The consequence of such immune response would be compromised myocardial oxygenation resulting in allograft failure.
Authors:
Yih-Leong Chang; Chien-Yu Lin; Shoei-Shen Wang; Kuan-Ting Kuo; Yung-Chie Lee; Chen-Tu Wu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Clinical transplantation     Volume:  16     ISSN:  0902-0063     ISO Abbreviation:  Clin Transplant     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-19     Completed Date:  2003-04-07     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8710240     Medline TA:  Clin Transplant     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  461-4     Citation Subset:  IM    
Affiliation:
Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Fatal Outcome
Graft Rejection / pathology
Heart Neoplasms / diagnosis,  pathology*,  surgery
Heart Transplantation*
Humans
Male
Myocardial Infarction / etiology,  pathology*
Myocardium / pathology
Neoplastic Cells, Circulating / pathology*
Pericardium / pathology
Rhabdomyosarcoma / diagnosis,  pathology*,  surgery
Transplantation, Homologous
Vasculitis / pathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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