PRACTICA 03 :

MALFORMACIONES CARDIACAS , CARDIOPATIAS

ISQUEMICA, TUMORES CARDIACOS,
ENFERMEDADES DEL MIOCARDIO Y PERICARDIO

DR. MARIO N. CASTRO RACCHUMI

R. ORLANDO VELASCO VELA

En el corazn se encuentran los CUERPOS DE ASCHOFF:

Focos de colgeno eosinofilo tumefacto
Rodeado de linfocitos (T)
Clulas plasmticas
Macrfagos redondeados (clulas de anitschkow) (patognomonico de la FR)
Clulas gigantes de aschoff

Focos de necrosis fibrilar

se encuentran clsicamente en elmiocardio. En orden decreciente se
encuentran en el septo interventricular y pared diafragmtica del
ventrculo izquierdo, msculo papilar posterior, cono pulmonar y pared

NODULOS O CUERPOS DE ASCHOFF

Clulas de anitschkow tienen citoplasma abundante y ncleo central entre

redondo y oval, con la cromatina dispuesta en forma de cinta ondulada delicada
(clulas en oruga)

Clulas en
oruga

La afectacin simultanea del endocardio y las vlvulas del lado izquierdo por focos inflamatorios
conduce en los casos tpicos a necrosis fibrinoide dentro de las cspides o a lo largo de las cuerdas
tendinosas sobre las que se asientan vegetaciones (precipitacin de fibrina en sitios de erosin)

ORGANO:
CORAZON

TIPO DE LESION:
CARDIOPATIA REUMATICA

DIAGNOSTICO DE LESION:
FIEBRE REUMATICA

MIOCRDIO NORMAL
Notar miocardicitos de dimetro normal, arranjados em
feixes paralelos. H pouco tecido conjuntivo no
interstcio.

CARDIOMIOPATIA HIPERTRFICA
Miocardicitos hipertrficos, dispostos em vrias direes.
Fibrose intersticial. Fotos respectivamente nos mesmos
aumentos.

MIOCRDIO NORMAL
Notar miocardicitos de dimetro normal, arranjados em
feixes paralelos. H pouco tecido conjuntivo no
interstcio.

CARDIOMIOPATIA HIPERTRFICA
Miocardicitos hipertrficos, dispostos em vrias direes.
Fibrose intersticial. Fotos respectivamente nos mesmos
aumentos.

El corazn en la cardiomiopatia hipertrofica muestra hirtrofia de la fibras

cardiacas asociado a fibrosis intersticial

ORGANO:
CORAZON

TIPO DE LESION:
CARDIOMIOPATA HIPERTRFICA

DIAGNOSTICO DE LESION:
HIPERTROFIA CARDIACA

Fibras
musculares
muertas no
contractiles
que las estiran
y ondulan

The earliest change histologically seen with acute myocardial infarction in the first day
is contraction band necrosis. The myocardial fibers are beginning to lose cross
striations and the nuclei are not clearly visible in most of the cells seen here. Note the

Myocardial infarct - circumscribed area of ischemic necrosis - coagulative necrosis. In the first 12 - 24 hours, myocardial
fibers are still well delineated, with intense eosinophilic (pink) cytoplasm, but lost their transversal striations and the
nucleus (left side of the picture). Notice a few myocardial fibers showing hypertrophy (increased size of the fiber, irregular

Recent myocardial infarct (in the

first 12 - 24 hours): myocardial
fibers are still well delineated, with
intense eosinophilic (pink)
cytoplasm, but lost their
transversal striations and the
nucleus. The interstitial space may
be infiltrated with red blood cells.
Make the distinction between
interstitial leucocytes (small,

In this microscopic view of a recent myocardial infarction,

there is extensive hemorrhage along with myocardial fiber
necrosis with contraction bands and loss of nuclei.

Recent myocardial infarct (first 24 hours) (detail). (H&E, ob. x20)

This high power microscopic view of the myocardium demonstrates an

infarction of about 1 to 2 days in duration. The myocardial cell nuclei have
almost all disappeared. There is beginning acute inflammation. Clinically,
such an acute myocardial infarction is marked by changes in the

This myocardial infarction is about 3 to 4 days old. There is an

extensive acute inflammatory cell infiltrate and the myocardial fibers
are so necrotic that the outlines of them are only barely visible.

This is an intermediate myocardial infarction of 1 to 2 weeks in age.

Note that there are remaining normal myocardial fibers at the top.
Below these fibers are many macrophages along with numerous

En la mayoria de los casos ,la cicatrizacin est

bastante avanzada al final de la sexta

ORGANO:
CORAZON

TIPO DE LESION:
CARDIOPATIA ISQUEMICA

DIAGNOSTICO DE LESION:
INFARTO DE MIOCARDIO

ORGANO:
VALVULA MITRAL

TIPO DE LESION:
VALVULOPATIA

DIAGNOSTICO DE LESION:
VALVULOPATIA POR FIEBRE
REUMATICA

ORGANO:
CORAZON

TIPO DE LESION:
TUMOR CARDIACO

DIAGNOSTICO DE LESION:
MIXOMA AURICULAR

ORGANO:
PERICARDIO

TIPO DE LESION:
PERICARDITIS FIBRINOSA

DIAGNOSTICO DE LESION:
PERICARDITIS REUMATICA /
TUBERCULOSA