Histopatholog y of Extracardiac Tissues in Endomyocardial Fibrosis

Abstract

Fifty-five necropsies of patients with cardiac lesions typical of endomyocardial fibrosis (EMF) and thirty-two patients with cardiac lesions typical of rheumatic heart disease were reviewed with respect to the light microscopy of the lung , liver, spleen, lymph nodes, kidney and urinary bladder. In the liver of eleven out of thirty-two cases of EMF, small granulomatous lesions containing lymphocytes, macrophage s and plasma cells were present. The finding was confined to livers (twenty in all) free of cirrhosis and thus within this subgroup occurred in 55° Similar granulomatous lesions were seen in the sections of four out of thirty (13°,,) non-cirrhotic livers of cases diagnosed as rheumatic heart disease. These findings are in support of an infective aetiology for EMF, and are consistent with the hypothesis that the infective agent may not be a normal parasite in man. Cirrhosis was found more frequently in E MF (as a group or as isolated left ventricular EMF) than in rheumatic heart disease. It is suggested that undue susceptibility of EMF patients to pathological processes leading to visceral fibrosis should be considered among other possibilities