Histopathological diagnosis of myocarditis

Abstract

Histopathological assessment of the endomyocardial biopsy represents a gold standard in diagnosis of myocarditis (MC). For a long time, the microscopic diagnosis relied on Dallas criteria. They defined MC on morphological grounds as a presence of inflammatory infiltrate accompanied by signs of myocyte damage. However, these criteria were abandoned due to large proportion of false negative results and substantial interpersonal variability in the histopathological evaluation. The immunohistochemistry was implemented in the diagnostic process as well. Morphological classification of MC is based on the type of the inflammatory infiltration. The most common type of MC in the routine bioptic practice is lymphocytic MC. Giant cell, granulomatous, neutrophilic and eozinophilic MC are less frequent. The aim of this work is to inform about the current level of knowledge in histopathological diagnostics of MC and, in relation to previous article “ Štěchovský, Adla, Bonaventura: Clinical perspective on the myocarditis and cardiomyopathies”, discuss also a different clinical and pathological view on this group of diseases.

Keywords: Dallas criteria; endomyocardial biopsy; histopathology; myocarditis.