PMC6331320_01
Histological findings on endomyocardial biopsy. (A) Diffuse geographic myocarditis with severe necrotic change and inflammatory infiltrate (H&E, x100). (B) Numerous multinucleated giant cells in nongranulomatous background. (C) Collection of inflammatory cells including variable numbers of giant cells (arrows), histiocyte, T-lymphocyte, and eosinophils. (D) The area with necrotic change and severe inflammation showed negative of desmin. (E) Histiocyte infiltration in myocardium (CD68 staining). (F) T-lymphocyte infiltrate in myocardium (CD3, Pan-T cell marker staining).. H&E = hematoxylin and eosin.
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F1
A 66-year-old woman was resuscitated from a cardiac arrest after completing 1 cycle of cardiopulmonary resuscitation (Supplementary Figure 1). Myocardial pathology confirmed her diagnosis of giant cell myocarditis (GCM) (Figure 1).
Follow-up endomyocardial biopsy. (A) On 12th day from starting immunosuppressive therapy, myocardial biopsy revealed a marked reduction of the inflammatory infiltrate and the absence of giant cells. The fibrotic and fatty change are seen in the area, where there was necrotic change before treatment (H&E, x200). (B) On 46th day, massive granulation tissue and fatty change without active myocardial damage was observed (H&E, x400).. H&E = hematoxylin and eosin.
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F2
Figure 2). Follow-up pathological examination showed resolving myocarditis on the 12th hospital day (Figure 2) at 5 weeks after starting treatment.