scholarly journals Value of 3D mapping‐guided endomyocardial biopsy in cardiac sarcoidosis

2021 ◽  
Author(s):  
Danielle M. Haanschoten ◽  
Ahmet Adiyaman ◽  
Nils A. ‘t Hart ◽  
Piet L. Jager ◽  
Arif Elvan
Keyword(s):  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis ◽  
3D Mapping

Importance of endomyocardial biopsy in distinguishing between cardiac sarcoidosis and giant cell myocarditis

2018 ◽  
Vol 131 (7-8) ◽  
pp. 186-187
Author(s):  
Petr Kuchynka ◽  
Tomas Palecek ◽  
Lukas Lambert ◽  
Antonin Fikrle ◽  
Ivana Vitkova ◽  
...  
Keyword(s):  
Giant Cell ◽  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis ◽  
Giant Cell Myocarditis

scholarly journals CLINICAL OUTCOMES OF IMMUNOSUPPRESSIVE THERAPY IN PATIENTS WITH SUSPECTED CARDIAC SARCOIDOSIS BY ENDOMYOCARDIAL BIOPSY RESULTS

2020 ◽  
Vol 75 (11) ◽  
pp. 1004
Author(s):  
Fatima Ezzeddine ◽  
Konstantinos Siontis ◽  
Andrew Rosenbaum ◽  
Lori Blauwet ◽  
Samuel Asirvatham ◽  
...  
Keyword(s):  
Immunosuppressive Therapy ◽  
Clinical Outcomes ◽  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis

Utility of Endomyocardial Biopsy in the Diagnosis of Cardiac Sarcoidosis

CHEST Journal ◽  
1986 ◽  
Vol 90 (4) ◽  
pp. 528-533 ◽  
Author(s):  
Scott J. Ratner ◽  
John J. Fenoglio ◽  
Philip C. Ursell
Keyword(s):  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis

A case of cardiac sarcoidosis with advanced atrioventricular block. Failure of endomyocardial biopsy diagnosis and success in detecting

2003 ◽  
Vol 18 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Hiroki Kasai ◽  
Jun-ichi Suzuki ◽  
Hiroshi Imamura ◽  
Yoshikazu Yazaki ◽  
Mitsuaki Isobe ◽  
...  
Keyword(s):  
Atrioventricular Block ◽  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis ◽  
Biopsy Diagnosis

scholarly journals Fulminant cardiac sarcoidosis resembling giant cell myocarditis: a case report

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Ginger Y Jiang ◽  
Qizhe Cai ◽  
E Wilson Grandin ◽  
Marwa A Sabe
Keyword(s):  
Giant Cell ◽  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis ◽  
Obstructive Coronary Artery Disease ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
High Dose ◽  
Rare Presentation ◽  
Ventricular Ejection Fraction ◽  
Giant Cell Myocarditis

Abstract Background Severe cardiac sarcoidosis (CS) can share clinical and histopathologic features with giant cell myocarditis (GCM). Case summary A 56-year-old female presented with 1 week of exertional chest pressure and dyspnoea. Echocardiogram demonstrated extensive regional dysfunction with left ventricular ejection fraction (LVEF) 38%. Cardiac catheterization revealed no obstructive coronary artery disease and cardiac index 1.5 L/min/m2. Cardiac magnetic resonance imaging (MRI) demonstrated diffuse late gadolinium enhancement. Positron emission tomography with fluorodeoxyglucose (FDG) (FDG-PET) computed tomography showed FDG uptake in the anteroseptal and anterior wall and no extracardiac activity. Endomyocardial biopsy (EMB) demonstrated fragments of endocardial fibrosis with mixed inflammatory infiltrate including histiocytic giant cells, which could be due to CS or GCM. She was initially treated for GCM with high dose steroids, tacrolimus, and mycophenolate mofetil. Repeat EMB was pursued and demonstrated multiple granulomas with sharp demarcation from adjacent uninvolved myocardium consistent with CS. A dual-chamber implantable cardioverter-defibrillator was placed, and immunosuppression was changed to prednisone alone with plan for infliximab. Discussion This case illustrates a rare presentation of fulminant isolated CS. Endomyocardial biopsy with sufficient tissue was critical to establish a diagnosis and initiate appropriate immunosuppression.

scholarly journals Prognosis and Outcomes of Clinically Diagnosed Cardiac Sarcoidosis Without Positive Endomyocardial Biopsy Findings

JACC: Asia ◽  
2021 ◽  
Author(s):  
Kengo Kusano ◽  
Kohei Ishibashi ◽  
Takashi Noda ◽  
Kenzaburo Nakajima ◽  
Kosuke Nakasuka ◽  
...  
Keyword(s):  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis

scholarly journals Histology of Cardiac Sarcoidosis with Novel Considerations Arranged upon a Pathologic Basis

2022 ◽  
Vol 11 (1) ◽  
pp. 251
Author(s):  
Shu Kato ◽  
Yasuhiro Sakai ◽  
Asako Okabe ◽  
Yoshiaki Kawashima ◽  
Kazuhiko Kuwahara ◽  
...  
Keyword(s):  
Endomyocardial Biopsy ◽  
Cardiac Sarcoidosis ◽  
Fatty Infiltration ◽  
Granulomatous Inflammation ◽  
Giant Cells ◽  
M1 Macrophage ◽  
Cutibacterium Acnes ◽  
Precise Diagnosis ◽  
Noncaseating Granulomas ◽  
Pathologic Basis

Sarcoidosis is a rare disease of isolated or diffuse granulomatous inflammation. Although any organs can be affected by sarcoidosis, cardiac sarcoidosis is a fatal disorder, and it is crucial to accurately diagnose it to prevent sudden death due to dysrhythmia. Although endomyocardial biopsy is invasive and has limited sensitivity for identifying granulomas, it is the only modality that yields a definitive diagnosis of cardiac sarcoidosis. It is imperative to develop novel pathological approaches for the precise diagnosis of cardiac sarcoidosis. Here, we aimed to discuss commonly used diagnostic criteria for cardiac sarcoidosis and to summarize useful and novel histopathologic criteria of cardiac sarcoidosis. While classical histologic observations including noncaseating granulomas and multinucleated giant cells (typically Langhans type) are the most important findings, others such as microgranulomas, CD68+ CD163− pro-inflammatory (M1) macrophage accumulation, CD4/CD8 T-cell ratio, Cutibacterium acnes components, lymphangiogenesis, confluent fibrosis, and fatty infiltration may help to improve the sensitivity of endomyocardial biopsy for detecting cardiac sarcoidosis. These novel histologic findings are based on the pathology of cardiac sarcoidosis. We also discussed the principal histologic differential diagnoses of cardiac sarcoidosis, such as tuberculosis myocarditis, fungal myocarditis, giant cell myocarditis, and dilated cardiomyopathy.

The Many Faces of Cardiac Sarcoidosis

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S63-S63 ◽  
Author(s):  
Virian Serei ◽  
Billie Fyfe-Kirschner
Keyword(s):  
Heart Failure ◽  
Lymph Node ◽  
Medical History ◽  
Endomyocardial Biopsy ◽  
Cardiac Transplantation ◽  
Cardiac Sarcoidosis ◽  
Mediastinal Lymph Node ◽  
Giant Cells ◽  
End Stage ◽  
Explanted Heart

Abstract Introduction Cardiac involvement by sarcoidosis, a disease characterized by nonnecrotizing granulomas of unknown etiology, is rare and affects up to 7% of sarcoidosis patients clinically, but with an autopsy prevalence of 15% to 90%. The clinical presentation, as well as macroscopic and microscopic findings in cardiac sarcoidosis patients, varies. Methods Retrospective clinical chart review and gross and microscopic examination of surgical specimen from two adult cardiac sarcoidosis patients with literature review were performed. Results Case 1: A 23-year-old woman with no past medical history presented with 2 months of heart failure symptoms following a viral gastrointestinal infection. Endomyocardial biopsy showed a dense chronic inflammatory infiltrate, without giant cells. Anterior mediastinal lymph node biopsy and left apical core showed effacement by nonnecrotizing granulomas with giant cells and multifocal calcification, supporting cardiac sarcoidosis. Twelve months later, she underwent cardiac transplantation. The explanted heart showed concentric ventricular scarring, which microscopically corresponded to myocardial fibrosis with scattered lymphocytic inflammation with no residual granulomas. Case 2: A 52-year-old man with a medical history significant for ischemic cardiomyopathy and cutaneous sarcoidosis with lung involvement presented with congestive heart failure. Endomyocardial biopsy and left apical core showed myocyte hypertrophy and scattered interstitial inflammation. Mediastinal lymph node showed nonnecrotizing granulomas, consistent with sarcoidosis. Eighteen months later, he underwent cardiac transplantation. The explanted heart showed biventricular dilatation with interstitial fibrosis. There was also mild diffuse inflammation and occasional granulomas with rare focal necrosis. Conclusion Though the gold standard for diagnosing cardiac sarcoidosis is demonstration of myocardial nonnecrotizing granulomas, the sensitivity of endomyocardial biopsy is low. This is due to sampling error and stage of disease. Chronic end-stage disease can lead to fibrous encasement of granulomas and end-stage heart failure, necessitating cardiac transplantation. Current guidelines employ a combination of clinical, radiologic, and histologic criteria for diagnosing cardiac sarcoidosis.

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