Cardiovascular Pathology最新文献

{"title":"Immuhistochemically-confirmed mitochondrial cardiomyopathy presenting as a conduction system hamartoma: A case report","authors":"Ryo Kaimori ,&nbsp;Kentaro Sakai ,&nbsp;Atsuhito Takeda ,&nbsp;Rina Hayata ,&nbsp;Shinji Yano ,&nbsp;Haruto Nishida ,&nbsp;Tsutomu Daa ,&nbsp;Shinjiro Mori","doi":"10.1016/j.carpath.2025.107764","DOIUrl":"10.1016/j.carpath.2025.107764","url":null,"abstract":"<div><div>Conduction system hamartoma (CSH) is a rare cardiac lesion characterized by the abnormal proliferation of Purkinje-like myocytes. It predominantly affects female infants and is often associated with sudden cardiac death. Recent studies have linked mitochondrial dysfunction, particularly complex I deficiency, with CSH. We report an autopsy case of an eight-month-old female infant who died suddenly following mild gastrointestinal symptoms. A gross examination revealed mild cardiac hypertrophy without nodular lesions. Histological analysis identified multifocal aggregates of Purkinje-like cells with clear or foamy cytoplasm, some forming well-circumscribed nodules in the non-compacted myocardium. Immunohistochemistry demonstrated a marked reduction in complex I expression, supporting mitochondrial dysfunction. Although prominent trabeculations and deep recesses suggestive of left ventricular noncompaction were observed, they did not meet the strict diagnostic criteria. This case supports the potential role of mitochondrial complex I deficiency as a key pathogenic mechanism in CSH and highlights the significance of detailed histopathological and immunohistochemical analyses for an accurate diagnosis, especially in cases of sudden unexplained infant death.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"79 ","pages":"Article 107764"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal rupture of a giant left coronary artery aneurysm in an infant with Kawasaki disease. A case report with systematic literature review","authors":"Jonathan K Lai ,&nbsp;José Luis López-Guillén ,&nbsp;Rae SM Yeung ,&nbsp;Mamoru Ayusawa ,&nbsp;Brian W McCrindle ,&nbsp;Anita Nagy","doi":"10.1016/j.carpath.2025.107766","DOIUrl":"10.1016/j.carpath.2025.107766","url":null,"abstract":"<div><div><strong>Kawasaki disease (KD)</strong> is a systemic vasculitis of childhood that may lead to coronary artery aneurysms. Rupture of a giant coronary aneurysm is an exceptionally rare but often fatal complication. We report the case of a 4-month-old infant with treatment-resistant Kawasaki disease who developed rapidly enlarging giant aneurysms in all coronary artery branches despite aggressive immunomodulatory therapy. The patient died from cardiac tamponade due to rupture of a giant left anterior descending coronary artery aneurysm. Full autopsy revealed widespread vasculitis affecting multiple visceral arteries in addition to coronary artery involvement. Histological analysis demonstrated panarteritis with medial destruction and no evidence of thrombosis or myocardial infarction. A systematic review of reported cases demonstrated comparable clinical patterns and outcomes. This report underscores the potential for systemic vascular involvement in severe Kawasaki disease and highlights the importance of early recognition and intensified treatment in refractory cases.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"79 ","pages":"Article 107766"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144931572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trimethylamine N-oxide drives bioprosthetic heart valve calcification via macrophage pyroptosis in juvenile rats","authors":"Diwen Li ,&nbsp;Shijun Hu ,&nbsp;Xueyang Gong,&nbsp;Yiliya Ahemaiti,&nbsp;Luyao Wei,&nbsp;Yuyang Huang,&nbsp;Yan Liang,&nbsp;Yongyi Wang,&nbsp;Tianli Zhao","doi":"10.1016/j.carpath.2025.107750","DOIUrl":"10.1016/j.carpath.2025.107750","url":null,"abstract":"<div><div>Bioprosthetic heart valves (BHVs) constructed from bovine pericardium (BP) are widely used in valve replacement due to their favorable biocompatibility. However, early structural degeneration, particularly in younger recipients, remains a critical challenge, primarily driven by calcification. Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite elevated by high-choline diets, has been implicated in vascular and valvular calcification, but its role in BHV deterioration remains unclear. This study aimed to evaluate the effects of TMAO on BP calcification. Three-week-old Sprague-Dawley rats were assigned to six diet groups: Normal Chow Diet (NCD), High Choline Diet (HCD), High Fat Diet (HFD), combined High Fat and Choline Diet (HFD+HCD), HFD with TMAO supplementation (HFD+TMAO), and HFD with both HCD and the TMAO inhibitor 3,3-dimethyl-1-butanol (DMB). BHVs made of BP were implanted subcutaneously, and after 8 weeks, we assessed calcium deposition, osteogenic markers, plasma metabolites, inflammatory cytokines, inflammatory cell proportions, and macrophage pyroptosis using techniques such as colorimetry, immunohistochemistry, ELISA, flow cytometry, and immunofluorescence. In vitro, RAW264.7 macrophages were exposed to TMAO, and pyroptosis was assessed by Western blotting, ELISA, and electron microscopy. Results indicated that HCD and HFD significantly increased BP calcification, osteogenic marker expression, and inflammatory responses in BHVs. The HFD+HCD and HFD+TMAO groups exhibited pronounced calcific and inflammatory effects, which were reduced by DMB. In vitro, TMAO induced macrophage pyroptosis, contributing to calcification. These findings suggest that TMAO promotes BP calcification through pyroptosis-driven inflammation, and that targeting TMAO via dietary or microbial modulation may offer a promising strategy to improve BHV durability, particularly in young patients.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"79 ","pages":"Article 107750"},"PeriodicalIF":2.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased angiogenesis and lymphangiogenesis in rheumatic mitral valves","authors":"Paavo Immonen ,&nbsp;Pranita Zare ,&nbsp;Ari Mennander ,&nbsp;Timo Paavonen ,&nbsp;Pradeep Vaideeswar ,&nbsp;Ivana Kholová","doi":"10.1016/j.carpath.2025.107744","DOIUrl":"10.1016/j.carpath.2025.107744","url":null,"abstract":"<div><div>Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) create a global burden in the field of cardiovascular medicine due to significant morbidity and mortality, particularly in low- and middle-income countries and the underprivileged population.</div><div>Sequential surgical specimens of mitral valves excised from 19 patients with moderate to marked rheumatic mitral stenosis were included in this study and compared to eight sequential surgical myxomatous degenerative valves (control). The study group population had a mean age of 43.8 (± standard deviation (SD) 13.3) years and comprised 10 female and nine male patients. The controls included three female and five male patients with a mean age of 61.5 (± SD 16.1) years.</div><div>In RHD, the lymphatic vessel size and count per mm² were increased compared to the degenerative valves. Statistical significance was found in the blood and lymphatic vessel size, and lymphatic vessel count. In RHD, the combined blood and lymphatic vessel size increased from 1.45µm² (± SD 2.52) to 4.91 µm² (± SD 6.33). The lymphatic vessel count was 1,123.86 per mm² (± SD 2,154.68) in the RHD and 213.08 per mm² (± SD 390.13) in the myxomatous degenerative valves. Angiogenesis and lymphangiogenesis characterize mitral valves in RHD.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107744"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A renal transplant recipient with a pulmonic valve mass","authors":"Ilyse Darwish ,&nbsp;Benoît de Varennes ,&nbsp;Pierre Olivier Fiset ,&nbsp;Sophie Camilleri-Broët ,&nbsp;Vynka Lash ,&nbsp;Marcelo Cantarovich ,&nbsp;Todd C. Lee ,&nbsp;Cecilia T. Costiniuk","doi":"10.1016/j.carpath.2025.107745","DOIUrl":"10.1016/j.carpath.2025.107745","url":null,"abstract":"<div><div>A 43-year-old female with a renal transplant presented with fatigue, dyspnea, anemia, and thrombocytopenia. Chest CT revealed pulmonary nodules, and transthoracic echocardiography identified a large, multi-lobulated, multi-cystic mass attached to the pulmonic valve. Pathology demonstrated fungal hyphae, and bronchoalveolar lavage (BAL) fluid grew <em>Aspergillus fumigatus</em>, with a serum Aspergillus galactomannan (GM) antigen index of 1.95. The pulmonic valve was excised and a bioprosthetic valve was inserted. The patient was treated with voriconazole. Pulmonic valve <em>Aspergillus</em> endocarditis (AE) is a rare condition associated with high mortality. Given the rising number of transplant recipients, heightened clinical vigilance is warranted in this population.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107745"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocytic myocarditis: A histopathologic definition and classification from the Society for Cardiovascular Pathology and Association for European Cardiovascular Pathology. I: Endomyocardial biopsy","authors":"Marc K. Halushka ,&nbsp;Giulia d’Amati ,&nbsp;Melanie C. Bois ,&nbsp;John T. Fallon ,&nbsp;Carla Giordano ,&nbsp;Karin Klingel ,&nbsp;Charles Leduc ,&nbsp;Richard N. Mitchell ,&nbsp;Stefania Rizzo ,&nbsp;Cristina Basso","doi":"10.1016/j.carpath.2025.107759","DOIUrl":"10.1016/j.carpath.2025.107759","url":null,"abstract":"<div><h3>Background and aim</h3><div>Lymphocytic myocarditis has long been appreciated as a lymphocyte-predominant myocardial inflammation with resultant myocyte injury. However, current methods of diagnosis on endomyocardial biopsy (EMB) lead to inconsistent diagnoses. To improve patient care, the criteria for the diagnosis of lymphocytic myocarditis on endomyocardial biopsies have been revised to address shortcomings of the Dallas Criteria and European Society of Cardiology (ESC) criteria.</div></div><div><h3>Methods and results</h3><div>In the Seaport area of Boston, a panel of expert cardiovascular pathologists from the Society for Cardiovascular Pathology (SCVP) and the Association for European Cardiovascular Pathology (AECVP) completed a three-year project to develop consensus terms and definitions. These “Seaport” criteria for EMB were developed to utilize CD3 immunohistochemistry for T lymphocytes and accurately define each level of histopathologic severity based on extent of infiltrate and presence of myocyte injury. These criteria create a diagnostic approach to lymphocytic myocarditis using three grades of severity (mild, moderate, and severe) along with a category of scattered increased T lymphocytes of undetermined significance (SITUS). The document discusses the role of ancillary studies, the relationship to other diagnostic modalities, and areas of continuing controversy in the development of these criteria.</div></div><div><h3>Conclusion</h3><div>These consensus-based criteria offer a standardized framework for diagnosing lymphocytic myocarditis in EMB. Adoption of these easy-to-use criteria will improve classification of lymphocytic myocarditis as an aid to diagnose and treat patients.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107759"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The anti-atherosclerosis effect and molecular mechanism of AMPKα1 by polarizing monocytes to an M2 phenotype via cell-intrinsic lysosomal lipolysis","authors":"Jing Wang ,&nbsp;Yahui Zhang ,&nbsp;Caixing Cao ,&nbsp;Jiale Hua ,&nbsp;Li Xing ,&nbsp;Changxin Wu","doi":"10.1016/j.carpath.2025.107742","DOIUrl":"10.1016/j.carpath.2025.107742","url":null,"abstract":"<div><div>Regulating the differentiation of monocytes into M2 macrophages can promote the regression of Atherosclerosis (AS) plaque. However, the key molecules regulating the differentiation of monocytes to M2 are unknown. In this study, we reported that adenosine-activated protein kinase α1 (AMPKα1) plays an anti-AS role by polarizing monocytes to an M2 phenotype via promoting fatty acid oxidation (FAO). AMPKα1 enhances the decomposition of cholesterol esters by increasing lysosomal acid lipase expression to provide fatty acids for FAO. Furthermore, AMPKα1 can induce lysosomal biogenesis and enhance lipolysis by promoting the transcription factor EB (TFEB) expression and facilitating TFEB nuclear translocation. In conclusion, AMPKα1 enhances the decomposition of cholesterol esters by increasing lysosomal acid lipase expression to produce fatty acids, which may represent a mechanism to promote FAO and inflammatory monocytes differentiation towards M2 phenotype.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107742"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vegetations and cerebral emboli of non-bacterial thrombotic endocarditis are overwhelmingly platelet-dominant: A possible histological clue for the diagnosis from an autopsy study","authors":"Tomoyuki Otani ,&nbsp;Chiyoko Terada-Ikeda ,&nbsp;Junpei Koge ,&nbsp;Hisao Shimizu ,&nbsp;Manabu Matsumoto ,&nbsp;Kisaki Amemiya ,&nbsp;Yoshihiko Ikeda ,&nbsp;Keiko Ohta-Ogo ,&nbsp;Emi Date ,&nbsp;Norishige Iizuka ,&nbsp;Akihiko Yoshizawa ,&nbsp;Kinta Hatakeyama","doi":"10.1016/j.carpath.2025.107746","DOIUrl":"10.1016/j.carpath.2025.107746","url":null,"abstract":"<div><div>As endovascular therapy for ischemic stroke has advanced, we are getting increasing opportunities to study cerebral thromboemboli histologically. These opportunities have not been fully exploited, but some reports suggest that thromboemboli retrieved from cancer patients with stroke are platelet-richer than those from non-cancer patients. Nonbacterial thrombotic endocarditis (NBTE) is an important cause of ischemic stroke in cancer patients. In this study, we analyzed 20 autopsy cases of NBTE (13 of which had advanced cancer), along with cases of cerebral embolism associated with atrial fibrillation (AF, <em>n</em> = 11) and infective endocarditis (IE, <em>n</em> = 7). The histological features of NBTE vegetations (<em>n</em> = 20) were fairly consistent among cases: they were overwhelmingly platelet-dominant and spatially homogeneous, containing few erythrocytes or inflammatory cells. They were little organized, if at all, and were not associated with valvular destruction. Cerebral emboli associated with NBTE (<em>n</em> = 7) were also platelet-dominant. Intracardiac thrombi/vegetations and cerebral emboli associated with AF and IE, in contrast, contained variable amounts of platelets and erythrocytes. NBTE vegetations/emboli, compared with AF thrombi/emboli, had significantly higher %platelet area (intracardiac vegetations/thrombi: 70 ± 15 % vs 33 ± 20 %, <em>p</em> &lt; 0.001; cerebral emboli: 65 ± 16 % vs 25 ± 22 %, <em>p</em> &lt; 0.001) and lower %erythrocyte area (vegetations/thrombi: 9 ± 7 % vs 61 ± 21 %, <em>p</em> &lt; 0.001; emboli: 20 ± 11 % vs 70 ± 9 %, <em>p</em> &lt; 0.001). These results suggest that some platelet-rich thrombi retrieved during mechanical thrombectomy for ischemic stroke in cancer patients are likely to have originated from NBTE. Clinical diagnosis of NBTE is often difficult, but histological analysis of retrieved thrombi may help identify this underdiagnosed condition.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107746"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocytic myocarditis: A histopathologic definition and classification from the society for cardiovascular pathology and association for European cardiovascular pathology. II: Surgical and autopsy specimens","authors":"Joseph J. Maleszewski ,&nbsp;Jytte Banner ,&nbsp;Hans de Boer ,&nbsp;Monica De Gaspari ,&nbsp;Michael C. Fishbein ,&nbsp;Sarah Parsons ,&nbsp;Barbara Sampson ,&nbsp;Mary N. Sheppard ,&nbsp;Allard C. Van der Wal ,&nbsp;James R. Stone ,&nbsp;Katarzyna Michaud","doi":"10.1016/j.carpath.2025.107748","DOIUrl":"10.1016/j.carpath.2025.107748","url":null,"abstract":"<div><h3>Background and aim</h3><div>Lymphocytic myocarditis, characterized by lymphocyte-predominant myocardial inflammation with associated myocyte injury, is a term that has decades-old histopathologic criteria when encountered on endomyocardial biopsy. However, the interpretation of non-biopsy specimens such as surgical resections and autopsy samples has lacked standardized histopathologic criteria, despite their growing clinical and forensic relevance. The aim was to develop and establish criteria for the diagnosis and classification of lymphocytic myocarditis in non-biopsy ventricular myocardial specimens.</div></div><div><h3>Methods and results</h3><div>An international panel of cardiovascular pathologists representing the Society for Cardiovascular Pathology (SCVP) and the Association for European Cardiovascular Pathology (AECVP) developed a new classification system, which was completed at a final meeting in the Seaport area of Boston. These “Seaport” criteria for non-biopsy specimens formally define lymphocytic myocarditis as myocardial inflammation predominantly composed of lymphocytes, accompanied by myocyte injury not attributable to other causes. Recommendations address specimen type, technical handling, diagnostic thresholds, and qualifiers of chronicity. Diagnostic categories include active myocarditis and lymphocytic infiltrate of uncertain significance (LIUS). The document also outlines the interpretive challenges in attributing causality in autopsy settings, provides guidance on the use of ancillary techniques, and highlights the limitations of current histopathologic approaches.</div></div><div><h3>Conclusion</h3><div>These consensus-based criteria offer a standardized framework for diagnosing lymphocytic myocarditis in non-biopsy specimens. Adoption of these guidelines is expected to improve diagnostic consistency, enhance research comparability, and inform clinical and forensic evaluations. Future efforts should aim to refine definitions of myocyte injury, validate ancillary techniques, and elucidate the clinical significance of inflammation in the absence of injury.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107748"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aorto-pericardial fistula in an intravenous drug addict with infective endocarditis of the aortic valve","authors":"Petr Handlos ,&nbsp;Klára Handlosová ,&nbsp;Vladimír Židlík ,&nbsp;Vladimíra Gebauerová ,&nbsp;Matěj Uvíra","doi":"10.1016/j.carpath.2025.107747","DOIUrl":"10.1016/j.carpath.2025.107747","url":null,"abstract":"<div><div>This paper presents a fatal case of a 31-year-old female intravenous amphetamine user in the late stage of pregnancy who suffered a sudden collapse at home. The autopsy revealed hemopericardium resulting from an aorto-pericardial fistula. Histological examination of the aortic valve revealed multiple abscesses. Moreover, the histological examination also proved the presence of foreign bodies in the fistula and a granulomatous reaction with numerous multinucleated giant cells surrounding the bodies in the wall of the aorto-pericardial fistula necrosis as well as purulent phlegmonous inflammation. The foreign bodies were positive for amphetamine and methamphetamine. These findings suggest that the aorto-pericardial fistula developed due to intravenous drug abuse.</div></div>","PeriodicalId":9451,"journal":{"name":"Cardiovascular Pathology","volume":"78 ","pages":"Article 107747"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144483244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}