"Slide" discussion (myocardium)

[Eurekanni]

Hello everyone,

These few slides are from an autopsy performed on a young diseased patient who had suffered from congenital heart disease.

The particular feature in these few slides is the focal, dark pigmented myocardium that appeared on H&E stain (as shown in the attachment),and that was not considered artifact of any kind after the second tissue section was done.

I would like if any one would give some hints on diagnosing this kind of pattern??

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[LADoc00]

Off the top of my head, given that history would guess Porphyria.

Get back to us on what on the answer is.

 

[Gene_]

It is hard to tell what the pigment is from the pictures. I would put iron in the differential, especially if it is refractile.

 

[yaah]

Still looks like an artifact to me - very odd sharply-defined pattern.

 

[KCShaw]

What sort of congenital heart disease (anatomic or other known findings, or just early physiologic failure and you're trying to figure out the rest post-mortem?), and how old are we talking about? Any other autopsy/histology abnormalities noted? Was this finding uniform in all heart sections (in different blocks)? What were the clinical circumstances/history leading up to death? Were newborn metabolic screen results normal/performed? Was skeletal muscle saved/submitted? Or are you "testing" the forum because you already know?

Certainly can't be very definitive with limited compressed digital images, and won't try to be. The "pigment"/discoloration does seem to have its own very distinct pattern, or area of involvement, which strikes me as unusual for pigment related disease. I would be particularly suspicious if there are no histologic findings in other organs. I wouldn't spend a lot of money on stains or EM without, at least, answers to the earlier questions.