Journal of Nippon Medical School: Vol.70 No.6 page.509

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ArticleTitle Long-term Remnants of Coagulation Necrosis of Cardiomyocytes Following Myocardial Infarction

AuthorList Hiroko Ohmori¹, Koichi Tamura^{2, 3}, Simpei Ono¹, Takayuki Ibi¹, Satoshi Hashimoto¹ and Yuichi Sugisaki^{2, 3}

Affiliation ¹Medical Student, Nippon Medical School
²Division of Surgical Pathology, Nippon Medical School Hospital
³Department of Pathology, Nippon Medical School

Language JA

Volume 70

Issue 6

Year 2003

Page 509-514

Received May 26, 2003

Accepted September 18, 2003

Keywords myocardial infarction, remnant necrotic tissue, immunohistochemistry, myoglobin, pathology

Abstract Remnants of cardiomyocytes showing coagulation necrosis in the scars caused by myocardial infarction were histopathologically studied. Among 305 autopsy cases of acute and/or healed myocardial infarction, 8 cases (7 men, 1 woman, ages 62∼87 years, mean age 72.1) had masses of cardiomyocytes with coagulation necrosis at the center of the infarction scars more than 3 weeks (21 to 79 days) after the attack of myocardial infarction. All these cases had transmural infarction and more than 80% of the wall thickness of the left ventricle was involved in the infarction. No polymorphonuclear leukocytic infiltration or granulation tissue was found in the necrotic area, but macrophages were observed in the peripheral area adjacent to the scar tissue. Immunohistochemical staining for myoglobin showed no reaction in remnant necrotic cells or pericellular interstitium, which was similar to findings in the necrotic area more than 4 days after the infarction. These findings are important in the pathological diagnosis to distinguish remnant necrosis from acute necrosis, because 4 out of 8 present cases (50%) were misdiagnosed as acute myocardial infarction that superimposed on the previous old infarction.

Correspondence to Koichi Tamura, MD, DMSc, Division of Surgical Pathology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
tamura@nms.ac.jp

ArticleTitle	Long-term Remnants of Coagulation Necrosis of Cardiomyocytes Following Myocardial Infarction
AuthorList	Hiroko Ohmori¹, Koichi Tamura^{2, 3}, Simpei Ono¹, Takayuki Ibi¹, Satoshi Hashimoto¹ and Yuichi Sugisaki^{2, 3}
Affiliation	¹Medical Student, Nippon Medical School ²Division of Surgical Pathology, Nippon Medical School Hospital ³Department of Pathology, Nippon Medical School
Language	JA
Volume	70
Issue	6
Year	2003
Page	509-514
Received	May 26, 2003
Accepted	September 18, 2003
Keywords	myocardial infarction, remnant necrotic tissue, immunohistochemistry, myoglobin, pathology
Abstract	Remnants of cardiomyocytes showing coagulation necrosis in the scars caused by myocardial infarction were histopathologically studied. Among 305 autopsy cases of acute and/or healed myocardial infarction, 8 cases (7 men, 1 woman, ages 62∼87 years, mean age 72.1) had masses of cardiomyocytes with coagulation necrosis at the center of the infarction scars more than 3 weeks (21 to 79 days) after the attack of myocardial infarction. All these cases had transmural infarction and more than 80% of the wall thickness of the left ventricle was involved in the infarction. No polymorphonuclear leukocytic infiltration or granulation tissue was found in the necrotic area, but macrophages were observed in the peripheral area adjacent to the scar tissue. Immunohistochemical staining for myoglobin showed no reaction in remnant necrotic cells or pericellular interstitium, which was similar to findings in the necrotic area more than 4 days after the infarction. These findings are important in the pathological diagnosis to distinguish remnant necrosis from acute necrosis, because 4 out of 8 present cases (50%) were misdiagnosed as acute myocardial infarction that superimposed on the previous old infarction.
Correspondence to	Koichi Tamura, MD, DMSc, Division of Surgical Pathology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan tamura@nms.ac.jp