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Lymph Vessel Proliferation on Cardiac Biopsy May Help in the Diagnosis of Cardiac Sarcoidosis
- Source :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
- Publication Year :
- 2019
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2019.
-
Abstract
- Background The diagnosis of cardiac sarcoidosis ( CS ) is challenging because endomyocardial biopsy has only a 20% to 30% sensitivity rate for diagnosis and it presents with similar clinical features of idiopathic dilated cardiomyopathy ( DCM ). Lymphatic vessel proliferation in pulmonary sarcoidosis has been previously demonstrated. In this study, we compared endomyocardial biopsy samples obtained from patients with CS and DCM to determine whether lymph vessel counts using D2‐40 immunostaining can be utilized as a complementary tool to distinguish CS from DCM . Methods and Results Endomyocardial biopsy tissues were obtained from 62 patients with CS (30 patients with a diagnosis made histologically, 32 patients with a diagnosis made clinically), and hematoxylin/eosin, Masson trichrome, and D2‐40 immunostaining were performed. Their results were compared with those from 53 patients with DCM. The histological CS group showed significantly increased lymphatic vessels (12.0 [4.0–40.0] versus 2.6 [1.9–3.4], P P DCM group. The optimal threshold was 7.5 lymphatic vessels, and this resulted in a sensitivity of 0.67 and specificity of 0.96. The clinical CS group diagnosed according to Japanese Circulation Society 2016 criteria showed increased lymphatic vessels (4.0 [3.3–9.0] versus 2.6 [1.9–3.4], P P P P =0.0012) compared with the DCM group. The optimal threshold of lymphatic vessels was 3.5, which resulted in a sensitivity of 0.75 and specificity of 0.68. Conclusions Lymphatic vessel counts using D2‐40 immunostaining may help to distinguish clinical CS without granuloma from DCM .
- Subjects :
- Male
Pathology
medicine.medical_specialty
Sarcoidosis
Biopsy
lymphatic vessel
H&E stain
Diagnostic Testing
030204 cardiovascular system & hematology
Pathophysiology
cardiac sarcoidosis
Masson's trichrome stain
03 medical and health sciences
0302 clinical medicine
Fibrosis
Idiopathic dilated cardiomyopathy
medicine
Lymphatic vessel
Humans
Aged
Cell Proliferation
Lymphatic Vessels
Retrospective Studies
Original Research
030304 developmental biology
Heart Failure
0303 health sciences
business.industry
Myocardium
Inflammatory Heart Disease
Middle Aged
medicine.disease
Lymphatic system
medicine.anatomical_structure
Granuloma
endomyocardial biopsy
cardiovascular system
Female
Lymph
Cardiomyopathies
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
D2‐40 immunostaining
Subjects
Details
- ISSN :
- 20479980
- Volume :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of the American Heart Association
- Accession number :
- edsair.doi.dedup.....17f127ece9eeb84964720b7c3b27e7d8