ABC | Volume 112, Nº6, June 2019

Anatomopathological Correlation Arq Bras Cardiol. 2019; 112(6):793-802 Issa and Benvenuti Pulmonary infiltrate and left ventricular apex obliteration in a young man and mid-apical left ventricular region, with underlying myocardial penetration, as well as an extensive organized and organizing thrombosis (Figure 12). The endocardium close to the myocardium consisted of looser collagen, with neovascularization foci, hemosiderin deposition, and discrete mononuclear inflammatory infiltrate. Eosinophils were not detected. The lungs weighed 1,134 g together and showed marked chronic passive congestion, with septal thickening and hemosiderin deposition, as well as foci of fibrin extravasation into the alveolar spaces, rare fibrin thrombi in the parenchymal arterioles and extensive recent bilateral alveolar hemorrhage. There was no vasculitis. The kidneys showed acute tubular necrosis, with no glomerular lesions, thrombi or vasculitis. The thyroid weighed 8g, showing extensive atrophy with fibrous replacement of the parenchyma; the remaining follicles showed variable sizes and there were rare foci of lymphohistiocytic inflammatory infiltrate. Other necropsy findings were steatonecrosis of abdominal fat and centrilobular hepatic necrosis with cholestasis. (Dr. Luiz Alberto Benvenuti) Anatomopathological diagnoses: Hypertrophic cardiomyopathy/endomyocardial fibrosis; chronic passive congestion of the lungs; thyroid fibrosis and atrophy; alterations secondary to cardiogenic hemodynamic shock (cause of death). (Dr. Luiz Alberto Benvenuti) Figure 9 – Longitudinal section of the heart, disclosing the ventricular inflow tract. The left cavity has decreased volume due to extensive organizing thrombosis, which surrounds the papillary muscles (asterisks). Figure 10 – Extensive thrombosis in the left ventricular cavity (double asterisk) extending to the outflow tract. Note the whitish, fibrous thickening of the endocardium (arrow) and absence of hypertrophic obstruction of the subaortic region (asterisk). 800