The heart wall (schematic). (WC/Wikiversity Journal of Medicine)

Pericardium is a specimen that uncommonly comes to pathology.

Pathologies of the pericardium

Benign

Idiopathic pericarditis - common.^[1]
Infectious pericarditis - post-procedural.
Fibrinous pericarditis.
Pericardial cyst.
- Rare - 1 in 100,000.^[2]
- Typical location: right cardiophrenic angle.^[2]

Malignant

Related pathologies

Pericardial effusion.
Hemopericardium.
Cardiac tamponade.

Specific entities

Idiopathic pericarditis

General

Uncommon.

Etiologies of pericarditis:^[2]

Infectious:
- Fungal.
- Bacterial.
Idiopathic - most common.
Neoplastic.
Autoimmune, e.g. systemic lupus erythematosus.
Uremia - chronic renal failure.
Traumatic - post-surgical.
Associated with myocardial infarction - Dressler's syndrome.

Gross

Features:^[2]

Thickening.
+/-Pericardial effusion.

Notes:

Normal pericardial fluid volume 5-35 mL.^[2]

Microscopic

Features:

Inflammatory cells:
- Neutrophils.
- Lymphocytes.
- Plasma cells.
+/-Hemosiderin-laden macrophages.

DDx:

Infectious pericarditis.
Malignant mesothelioma.^[1]

Images

AP - intermed. mag. (WC)
AP - high mag. (WC)
AP - very high mag. (WC)

Sign out

PERICARDIUM, BIOPSY:
- ACUTE AND CHRONIC PERICARDITIS WITH SIDEROPHAGES AND REACTIVE MESOTHELIAL CHANGES.
- NO MICRO-ORGANISMS SEEN WITH ROUTINE STAINING.
- NO EVIDENCE OF MALIGNANCY.

Micro

The sections show fibrous tissue with minimal adipose tissue that is covered by mesothelium. A mixed inflammatory infiltrate is present that consists primarily of lymphocytes and plasma cells. Rare eosinophils are seen. Focally, neutrophils are seen and associated with reactive mesothelial cells. Abundant hemosideratin-laden macrophages are seen. No fibrinous strands are seen. No significant nuclear atypia is identified and no atypical infiltrative cell population is identified. No micro-organisms are identified with routine staining.

References

↑ ^1.0 ^1.1 Smets P, Guettrot-Imbert G, Hermet M, et al. (September 2013). "[Recurrent pericarditis related to primary pericardial malignant mesothelioma]" (in French). Rev Med Interne 34 (9): 573–6. doi:10.1016/j.revmed.2013.04.021. PMID 23773902.
↑ ^2.0 ^2.1 ^2.2 ^2.3 ^2.4 Peebles CR, Shambrook JS, Harden SP (December 2011). "Pericardial disease--anatomy and function". Br J Radiol 84 Spec No 3: S324–37. doi:10.1259/bjr/16168253. PMC 3473919. PMID 22723538. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473919/.

[pmid23773902-1] 1.0 ^1.1 Smets P, Guettrot-Imbert G, Hermet M, et al. (September 2013). "[Recurrent pericarditis related to primary pericardial malignant mesothelioma]" (in French). Rev Med Interne 34 (9): 573–6. doi:10.1016/j.revmed.2013.04.021. PMID 23773902.

[pmid22723538-2] 2.0 ^2.1 ^2.2 ^2.3 ^2.4 Peebles CR, Shambrook JS, Harden SP (December 2011). "Pericardial disease--anatomy and function". Br J Radiol 84 Spec No 3: S324–37. doi:10.1259/bjr/16168253. PMC 3473919. PMID 22723538. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3473919/.

[1]

[2]

Pericardium

Contents