Histology Course S III 4 Departement of Pathology, University of Zurich Histokurs

S III 4 fresh myocardial infarction HE further information (German) on HiPaKu
  ICD-10: I21

62-year-old male; died 3 days after admission for myocardial infarction with cardiogenic shock. Creatine kinase (CK) reached a level of 1300E/I (normal range male:11-50, normal range female: 7-32). Lung oedema. Autopsy specimen.

- Macroscopically circumscribed yellowish-brown zone in anterior wall and anterior septal area with thrombotic occlusion of the proximal anterior descending branch (see specimen SIII10)
- An overview shows pale clusters with a basophilic border in the interior part
- The pale clusters have few cells and thin wavy muscle fibres.
- Basophilic border: the more pale necrotic areas are demarcated by densely lying, partly degenerating granulocytes
- Outer layer: hypereosinophilic clusters partly accompanied by granulocytic infiltrates (acute myocardial necrosis)
- Inner layer: a rim of subendocardial muscle tissue remains (supplied with oxygen by diffusion), infiltrated by granulocytes (moving towards necrotic areas)