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Case Reports
. 2024 Nov 20;29(22):102738.
doi: 10.1016/j.jaccas.2024.102738.

Giant Cell Myocarditis vs Cardiac Sarcoidosis: Reconsidering the Diagnosis With FDG PET Imaging

Ethan J Fraser  1 , Austin Culver  2 , Phillip H Lam  2   3 , Mark Hofmeyer  2   3 , Farooq H Sheikh  2   3 , Richa Gupta  2   3
Affiliations
Case Reports

Giant Cell Myocarditis vs Cardiac Sarcoidosis: Reconsidering the Diagnosis With FDG PET Imaging

Ethan J Fraser et al. JACC Case Rep. .

Abstract

Giant cell myocarditis (GCM) and cardiac sarcoidosis share clinical and histologic features, but whether they represent separate processes or lie on an inflammatory cardiomyopathy spectrum is unclear. We present a case of cardiogenic shock thought to be secondary to biopsy-proven GCM with a subsequent post-transplant diagnosis of sarcoidosis through 18-fluorodeoxyglucose positron emission tomography and biopsy.

Keywords: cardiac sarcoidosis; giant cell myocarditis; inflammatory cardiomyopathy.

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Conflict of interest statement

Dr Sheikh has received institutional research support from Abbott, Alnylam, and Akcea; has received honoraria for educational presentations from Abbott; and has served as a consultant for Alnylam. Dr Gupta has served as a consultant for and has received honoraria for educational presentations from CVRx. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

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Graphical abstract
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Visual Summary. Clinical Timeline Longitudinal view of all relevant clinical events and timing of diagnoses are summarized. Bx = biopsy; GCM = giant cell myocarditis; HF = heart failure; PET = positron emission tomography; SCC = squamous cell carcinoma.
Figure 1
Figure 1
Initial Endomyocardial Biopsy and Native Heart Pathology Findings (A) Endomyocardial biopsy with evidence of giant cells. (B) Pathologic features of the explanted heart with evidence of giant cells.
Figure 2
Figure 2
Post-Transplant Fluorine-18 Fluorodeoxyglucose PET Scan Fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging demonstrates hilar FDG avidity.
Figure 3
Figure 3
Post-Transplant Lymph Node Biopsy (A) Biopsy pathology findings of fluorine-18 fluorodeoxyglucose (FDG)-avid lymph node, revealing noncaseating granuloma. (B) Biopsy pathology findings of FDG-avid lymph node with negative acid-fast bacilli stain.
Figure 4
Figure 4
Clinical Differences and Overlap Between Giant Cell Myocarditis and Cardiac Sarcoidosis Salient pathologic and clinical differences between the 2 inflammatory processes. AV = atrioventricular; EMBx = endomyocardial biopsy; IV = intravenous.
See this image and copyright information in PMC

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References

    1. Bang V., Ganatra S., Shah S.P., et al. Management of patients with giant cell myocarditis. J Am Coll Cardiol. 2021;77:1122–1134. - PubMed
    1. Kociol R.D., Cooper L.T., Fang J.C., et al. Recognition and initial management of fulminant myocarditis: a scientific statement from the American Heart Association. Circulation. 2020;141(6):e69–e92. - PubMed
    1. Kouranos V., Sharma R. Cardiac sarcoidosis: state-of-the-art review. Heart. 2021;107:1591–1599. - PubMed
    1. Nordenswan H., Lehtonen J., Ekström K., et al. Manifestations and outcome of cardiac sarcoidosis and idiopathic giant cell myocarditis by 25-year nationwide cohorts. J Am Heart Assoc. 2021;10 - PMC - PubMed
    1. Okura Y., Dec G.W., Hare J.M., et al. A clinical and histopathologic comparison of cardiac sarcoidosis and idiopathic giant cell myocarditis. J Am Coll Cardiol. 2003;41:322–329. - PubMed

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