PathWays Case Study: Feb. 28

A 75-year-old man with a history of an aortic valve replacement, pacemaker placement, and severe mitral valve calcification develops a high-grade malignancy involving his liver. He completes a single round of chemotherapy, but continues to develop worsening liver failure. He succumbs to his underlying malignancy several days later. At autopsy, he has a moderately enlarged heart with an intact mechanical aortic valve, appropriate pacemaker lead placements, and severe mitral annular calcification. The myocardium is without any gross abnormality (focal greenish-yellow areas are due to bilirubinemia) (Figure 1). Microscopy, though, reveals multiple focal lesions throughout the myocardium in no particular distribution (Figure 2).

 

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Justin Juskewitch, M.D., Ph.D.

Justin Juskewitch, M.D., Ph.D.
Resident, Division of Anatomic and Clinical Pathology
Mayo Clinic

 

 

Marie Christine Aubry, M.D.

Marie Christine Aubry, M.D.
Consultant, Division of Anatomic Pathology
Mayo Clinic
Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine

 

William Edwards, M.D.
Consultant, Division of Anatomic Pathology
Mayo Clinic
Professor of Laboratory Medicine and Pathology,
Mayo Clinic College of Medicine

apriljosselyn

April Josselyn

April Josselyn is a Marketing Associate at Mayo Medical Laboratories. She is the editor of Mayo Clinic PathWays and supports corporate communications strategies and internal communications. She has worked at Mayo Clinic since 2012. Outside of work, April enjoys the outdoors and being "hockey mom" for her two sports-crazed boys.

Responses

Catecholamines myocarditis. .

Fungal myocarditis .

A nice case with fairly detailed explanations on the inaccurate answers too.

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