PMC3034660_01
Myocardial findings in case 1. (A) Infiltration of polymorphonuclear leukocytes (CD15), without fibrin or hemorrhage, into the dead myocardial tissue. (B) Immunohistochemical analysis for the phenotypic characterization of the cells revealed a positive reaction to the antibody directed against of polymorphonuclear leukocytes (CD15). (C) Confocal laser microscopy: double immunohistochemical reactions for the phenotypic characterization revealed a positive reaction to the antibodies directed against of CD45 (blue reaction) and CD15 (green reaction). (D) Myocyte nuclei labelled by TUNEL assay (apoptosis) revealed an intensive, wide, positive reaction (brown nuclei).
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F1
Histologically, the heart presented focal myocytes necrosis with massive and diffuse polymorphonuclear leukocytes infiltrate, especially on the anterior left ventricular samples to demonstrate an early myocardial infarction (Figure 1A-D).
Myocardial findings in case 2. (A) Colliquative myocytolysis. Perinuclear disappearance of myofibrils with intramyocardial edema resulting in an empty sarcolemmal tube seen in transverse sections. Note the absence of any type of cellular reaction. (B) Contraction band necrosis: intense hypereosinophilia of the hypercontracted myocardial cells with rhexis of the myofibrillar apparatus into cross-fiber, anomalous, and irregular or pathological bands. The latter are formed by segments of hypercontracted sarcomeres with scalloped sarcolemma. (C) Confocal laser microscopy: CD68 showed a strong reaction in the heart where intense hypereosinophilia of the hypercontracted myocardial cells with rhexis of the myofibrillar apparatus into cross-fiber, anomalous, and irregular or pathological bands is described. (D) Confocal laser microscopy: myocyte nuclei labelled by TUNEL assay (apoptosis) revealed an intensive, wide, positive reaction (green nuclei).
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F2
Myocardium showed focal myocytes necrosis and a typical picture of colliquative myocytolysis with loss of myofibrils paralleled by intramyocellular edema (Figure 2A-D).