ABC | Volume 110, Nº6, June 2018

Anatomopathological Correlation Arduine & Aiello Female patient with chagas disease, heart failure and cachexia Arq Bras Cardiol. 2018; 110(6):588-596 Figure 10 – Cut surface of the lung showing an ill-defined nodule with necrotic center (arrow). Figure 11 – Gross examination of the longitudinally opened trachea on its posterior face. In the subcarinal region, confluent lymph nodes with whitish nodular areas are seen (arrows). bodies. In the past, such bodies were known to be associated with alcoholic liver disease. However, several studies have shown the pathogenic role of amiodarone and its metabolites on the development of liver disease. 9,10 Those substances accumulate in the hepatocytes, Kupffer cells and ductal cells, resulting in inhibition of the removal of lysosomal lipids. Hepatotoxicity occurs in 1% to 3% of the patients treated with amiodarone and seems to be dose-dependent (cumulative). However, the prevalence of pulmonary toxicity is higher, estimated at 5% to 7%. We believe that the liver damage contributed to the changes in coagulation that culminated in hemothorax. There was no time to initiate the specific treatment against tuberculosis, which might have had a positive impact on this patient’s outcome. (Vera Demarchi Aiello, Prof., M.D.) 595