DIFFERENT HISTOPATHOLOGICAL APPEARANCES OF CARDIAC TUBERCULOSIS: PRESENTATION OF A RARE CASE WITH REVIEW OF LITERATURE

Authors

SURGICAL PATHOLOGY LABORATORY, SHAHEED RAJAIE CARDIOVASCULAR, MEDICAL AND RESEARCH CENTER, TEHRAN UNIVERSITY OF MEDICAL SCIENCES, MELLAT PARK, VALI ASR AVE., TEHRAN, IRAN

Abstract

Tuberculosis is caused by a mycobacterium and is a multipotential, omnipresent infectious disease. Generally, two major categories, pulmonary and extrapulmonary exist. Whereas pericardial involvement is relatively common, myocardial tuberculosis has been reported in not more than 0.3% of all tuberculosis patients post-mortem.
A 21-year-old woman sought medical attention due to progressive dyspnea upon exertion, weight loss, and general weakness. She underwent a heart operation and a well-circumscribed, solid, and creamy egg-shaped mass with a lobulated surface was seen in the right atrium. The histopathological study showed multiple well-formed granulomas with multinucleated giant cells and extensive caseous necrosis. These were compatible with a diagnosis of tuberculoma; however, the Ziehl-Neelsen stain failed to reveal the acid-fast bacilli. Her postoperative course was uneventful and soon she was discharged with advice to continue her medical therapy.

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