Heart, Myocardium - Necrosis






comment:
The peracute to acute stage of myofiber necrosis ( Figure 1




Necrosis can be one of the morphologic manifestations seen in cardiotoxicity (i.e., myofiber vacuolation, mononuclear cell infiltration, and fibrosis) or may be the predominant component in relatively early stages of spontaneous cardiomyopathy. Necrosis may also result from ischemia (infarct); these areas tend to be larger and are typically well circumscribed ( Figure 6


recommendation:
Heart, Myocardium - Necrosis should be diagnosed and graded if it is determined to be a separate entity and not part of cardiomyopathy. Necrosis should be graded based on the extent and/or number of lesions. The distribution of the necrosis (i.e., focal or multifocal), as well as the location (i.e., right or left atrium; right, left, or interventricular wall) should be described in the pathology narrative. Infarcts should be diagnosed as necrosis, and its pathogenesis (i.e., ischemia) should be noted in the pathology narrative. If the necrosis is secondary to another lesion, such as inflammation, it should not be diagnosed separately unless warranted by severity. Likewise, lesions that are considered secondary to necrosis (e.g., inflammation, hemorrhage) should not be diagnosed separately unless warranted by severity.references:
Dunnick J, Johnson JA, Horton J, Nyska A. 2004. Bis(2-chloroethoxy)methane-induced mitochondrial and myofibrillar damage: Short-term time-course study. Toxicol Sci 81:243-252. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/15201436
Dunnick JK, Lieuallen W, Moyer C, Orzech D, Nyska A. 2004. Cardiac damage in rodents after exposure to bis(2-chloroethoxy)methane. Toxicol Pathol 32:309-317. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/15204972
Elmore SA, Berridge BR, Boyle MC, Cora MC, Hoenerhoff MJ, Kooistra L, Laast VA, Morrison JP, Rao D, Rinke M, Yoshizawa K. 2012. Proceedings of the 2012 National Toxicology Program Satellite Symposium. Toxicol Pathol 41(2):151-180. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/23262640
Jokinen MP, Lieuallen WG, Johnson CL, Dunnick J, Nyska A. 2005. Characterization of spontaneous and chemically induced cardiac lesions in rodent model systems: The National Toxicology Program experience. Cardiovasc Toxicol 5:227-244. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/16046796
Jokinen MP, Boyle M, Lieuallen WG, Johnson CL, Malarkey DE, Nyska A. 2011. Morphologic aspects of rodent cardiotoxicity in a retrospective evaluation of National Toxicology Program studies. Toxicol Pathol 39(5):850-860. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21747121
Web page last updated on: April 18, 2017