ABSTRACT
The specialized conducting systems of 44 hearts with posterior-inferior acute myocardial infarction were studied to clarify the anatomic basis of atrioventricular (AV) block. The results showed a lack of correlation between the block and the lesional pathology of the specialized conducting system. On the other hand, an evaluation of the atrial prenodal myocardium revealed strong clinicopathologic correlation between the block and the necrotic damage to these fibers. Twenty-nine or 97% of patients with AV block showed acute necrosis of the prenodal atrial myocardium. Considering the conducting prenodal septal atrial myocardium as a suprahisian structure, the necrosis at this level would provide an anatomic basis of the block in posterior-inferior acute myocardial infarction. Analysis of the behavior of the AV block after pharmacologic treatment further established a relationship between the block and acute lesions in the central conduction system.
Subject(s)
Heart Block/pathology , Myocardial Infarction/pathology , Aged , Aged, 80 and over , Coronary Angiography , Coronary Vessels/pathology , Female , Heart Atria/pathology , Heart Block/drug therapy , Heart Block/etiology , Heart Conduction System/pathology , Humans , Male , Middle Aged , Myocardial Infarction/complications , NecrosisABSTRACT
A case of Langerhans' cell granulomatosis associated with gastric adenocarcinoma is reported. A review of the literature demonstrate an association of this entity with Hodgkin or non-Hodgkin lymphomas alone. The discussion is centred on differential diagnosis from the pseudo-sarcoid granulomatous reaction. Further reports may assist in classifying the granulomatous reaction to tumours into two types, epithelioid and Langerhans.
