cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2022.2.n1193cardio-1193Research ArticleКЛИНИЧЕСКИЙ СЛУЧАЙCLINICAL CASE REPORTМорфологические и иммуногистохимические особенности поражения миокарда при миастенииMorphological and immunogistochemical characteristics of myocardial damage in miasteniahttps://orcid.org/0000-0001-8476-5606ТодоровС. С.TodorovS. S.

руководитель морфологического отдела Ростовского ГМУ, врач-патологоанатом высшей категории, доктор медицинских наук

 

Head of the morphological department of the Rostov State Medical University, pathologist of the highest category, doctor of medical sciences

 

sertodorov@gmail.comhttps://orcid.org/0000-0003-4541-6707ДерибасВ. Ю.DeribasV. J.

заведующая патологоанатомическим отделением, ассистент кафедры патологической анатомии РостГМУ, врач-патологоанатом высшей категории

 

Head of the Pathology Department, Assistant of the Department of Pathological Anatomy, Rostov State Medical University, Pathologist of the highest category

 

deribasv@gmail.comhttps://orcid.org/0000-0003-0934-3416КазьминА. С.KazminA. S.

ассистент кафедры патологической анатомии РостГМУ, врач-патологоанатом высшей категории

 

Assistant, Department of Pathological Anatomy, Rostov State Medical University, pathologist of the highest category

 

kazmin_as@mail.ruТодоров (мл.)С. С.Todorov (jr)S. S.

студент   лечебно-профилактического факультета РостГМУ

student of the medical and preventive faculty of Rostov State Medical University

todorov-00@inbox.ruФГБОУ ВО "Ростовский государственный медицинский университет" Минздрава России, Ростов-на-ДонуРоссияRostov State Medical University, Rostov-on-DonRussian FederationФГБОУ ВО "Ростовский государственный медицинский университет" Минздрава РоссииРоссияRostov State Medical University, Rostov-on-DonRussian Federation2022280220226224751Copyright © Kardiomag, 20222022KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/1193

Представлено редкое клиническое наблюдение больного 45 лет, страдавшего генерализованной формой миастении с поражением мышечного аппарата конечностей и сердца. Особенностью случая было поражение миокарда в виде альтеративно-продуктивного интерстициального миокардита, имевшего своеобразный иммунофенотип клеточного инфильтрата: Cd3+, Cd4+, Cd8–, Cd68+. При этом клетки, экспрессирующие Cd68, были представлены крупными макрофагами с цитоплазматической зернистостью, которые окружали поврежденные кардиомиоциты. Вокруг участков альтерации кардиомиоцитов имелись явления неоангиогенеза с признаками экспрессии белка Cd34 в тонкостенных сосудах капиллярного типа. Описанные морфологические и иммуногистохимические изменения в миокарде дополняют представление о морфогенезе миастении.

The article presents a rare clinical case of a 45-year-old patient with generalized myasthenia with damages to the muscular apparatus of the extremities and the heart. A special feature of the case was myocardial damage evident as alterative-productive interstitial myocarditis with a peculiar immune phenotype of cell infiltrate, Cd3+, Cd4+, Cd8–, Cd68+. Furthermore, Cd68-expressing cells were presented by large macrophages with cytoplasmic granulation, which surrounded damaged cardiomyocytes. Around sites of cardiomyocyte alteration there were manifestations of neoangiogenesis with signs of Cd34 protein expression in thin-wall, capillary type blood vessels. These morphological and immunohistochemical changes in the myocardium supplement the concept of myasthenia morphogenesis.

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The authors declare that there are no conflicts of interest present.