Abstract:
:Endomyocardial biopsy (EMB) is a highly-specialised procedure that is associated with some controversy as to its diagnostic role due to its inconsistency in diagnosing a wide variety of cardiac diseases. Given the advances and sophistication in echocardiography and cardiac magnetic resonance imaging (MRI), the vast majority of cardiac diseases can be diagnosed by these non-invasive procedures. Under-sampling and the fact that biopsy site is limited to the right side of the interventricular septum further limits its value. In spite of all these limitations, there still remains a group of pathological conditions that require biopsy for a conclusive diagnosis such as myocarditis, amyloidosis, sarcoidosis and giant cell myocarditis. Correct patient selection and the quantity of tissue samples impart a significant influence on the accuracy of the diagnosis, and thus the value of EMB is variable for each patient. The purpose of this study was to evaluate the role of EMB in patient care, through its ability to either change clinical diagnosis or alter patient management. Our study was based in a single teaching centre. An audit of cardiac biopsies performed over a 10 year period identified 250 patients. We assessed indications, histology, electron microscopic findings, final clinical diagnosis and how they influenced patient management. A definite diagnosis on histology was given in 44 of 250 patients (17.6%). Non-specific findings were observed in the remaining 206 patients (82.4%). Histology influenced patient management in 73 (29.2%) patients. Histological examination in the remaining 177 biopsies (70.8%) did not provide a definite diagnosis or influence patient management. It was additionally found that the number of tissue fragments sampled has significant impact on diagnostic accuracy. A more accurate diagnosis of 45% was obtained when ≥5 fragments were sampled, as compared to 1-3 fragments where accuracy dropped to 20%. Our study indicated that sampling for electron microscopy has very limited value. We found that of 245 biopsies sampled for electron microscopy, only three biopsies (1.2%) had diagnostically useful findings. In our institution procedure related complications were observed in 7 of 250 patients (2.8%). The diagnostic value of EMB is important but limited. Strict triaging of patients according to clinical suspicion and adequate sampling of tissue may increase useful diagnostic information.
journal_name
Pathologyjournal_title
Pathologyauthors
Khan T,Selvakumar D,Trivedi S,Rao K,Harapoz M,Thiagalingam A,Denniss AR,Varikatt Wdoi
10.1016/j.pathol.2017.08.004subject
Has Abstractpub_date
2017-12-01 00:00:00pages
750-756issue
7eissn
0031-3025issn
1465-3931pii
S0031-3025(17)30213-1journal_volume
49pub_type
杂志文章相关文献
PATHOLOGY文献大全abstract::A 59 yr old male presented with abdominal pain and jaundice. CT scan showed a tumor in the pancreas with secondaries in the liver, peri-pancreatic lymph nodes, vertebral bone marrow and subcutaneous tissue of the neck together with a cervical lymph node. The patient died after 2 wks and autopsy revealed complete repla...
journal_title:Pathology
pub_type: 杂志文章,评审
doi:10.3109/00313029309066580
更新日期:1993-07-01 00:00:00
abstract:AIM:Gasdermin-like (GSDML) is a novel member of the cancer associated gasdermin-domain containing (GSDMDC) protein family. The GSDMDC family has been linked to cancer development and progression, and this is the first study analysing the expression and intracellular localisation of GSDML. METHODS:GSDML gene transcript...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313020701716250
更新日期:2008-01-01 00:00:00
abstract::Co-operation by outside centres has made it possible to offer bone marrow chromosome analysis to patients living up to 1800 kilometres from the central cytogenetics laboratory. Diagnostic karyotypes have been obtained in 9 of 10 bone marrow specimens which were partially processed before being transported to the city ...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313027809063513
更新日期:1978-07-01 00:00:00
abstract::The cell surface markers of 75 cases of non-Hodgkin's lymphoma were studied on cryostat sections using a panel of monoclonal antibodies. Forty-nine cases (65.3%) were found to express a B-cell phenotype, 23 cases (30.7%) a T-cell phenotype, 1 case (1.3%) a histiocytic phenotype and 2 cases (2.7%) no demonstrable surfa...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028609087562
更新日期:1986-10-01 00:00:00
abstract:AIM:To compare the relative diagnostic efficacy of several different tests used to establish a diagnosis of phaeochromocytoma, in patients with a proven diagnosis of phaeochromocytoma, and in hospital patients with significant disease of other types. METHODS:We prospectively compared biochemical markers of catecholami...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313020802579284
更新日期:2009-02-01 00:00:00
abstract::The sections in the following review cover six main neurodegenerative diseases. The first article on Alzheimer's disease (AD) outlines the major evidence available to date that links Aβ-amyloid peptide as a proximal cause of AD. The article also highlights how an initial finding of the protein content of the amyloid p...
journal_title:Pathology
pub_type: 杂志文章,多中心研究,评审
doi:10.1097/PAT.0b013e3283426eee
更新日期:2011-02-01 00:00:00
abstract::The aim of this study was to subcategorise large cell carcinoma (LCC) with null immunophenotype according to the World Health Organization (WHO) Classification of 2015 into the existing groups of adenocarcinoma and squamous cell carcinoma by further molecular genetic analysis. Lineage-specific molecular alterations of...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1016/j.pathol.2018.03.005
更新日期:2018-08-01 00:00:00
abstract:AIMS:To demonstrate the correlation between morphological and proliferation parameters with the biological behaviour of adrenocortical tumours (ACTs) in different age groups. METHODS:Seventy-six cases of ACT were evaluated comparing tumours of children (< or =15 years, n=24) and adults (>15 years, n=52) regarding morp...
journal_title:Pathology
pub_type: 杂志文章
doi:
更新日期:2003-04-01 00:00:00
abstract::Trichostrongylus infection, an uncommonly reported zoonosis in Australia, is common in parts of the world where there is close human contact with herbivorous animals. We report 5 cases diagnosed in our laboratory since 1992. Over this period the laboratory has conducted over 46,000 parasitological examinations on fece...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313029500169842
更新日期:1995-04-01 00:00:00
abstract:AIMS:Immunohistochemical detection of the 185-kDa transmembrane glycoprotein product of the proto-oncogene c-erbB-2 (also known as HER-2/neu), located on chromosome 17q21, is a well established method of evaluation in invasive breast cancer. This investigation is currently performed on standard sections cut from the tu...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313020600820872
更新日期:2006-08-01 00:00:00
abstract::Oral cancer is a serious public health problem, with over 200,000 new cases reported annually worldwide, two-thirds of which occur in developing countries. The overall mortality rate for intra-oral cancer remains high at approximately 50%, even with modern medical services, probably due to the advanced stage of the di...
journal_title:Pathology
pub_type: 杂志文章,评审
doi:10.1080/00310290310001602558
更新日期:2003-10-01 00:00:00
abstract:AIMS AND METHODS:During colorectal carcinogenesis, transforming growth factor beta 1 (TGF-beta1) undergoes a functional change from suppression of cancer cell proliferation to inhibition of T cell mediated anti-cancer immunity. We aimed to evaluate relations among TGF-beta1 and cancer cell survival factors hypoxia indu...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313020802579318
更新日期:2009-01-01 00:00:00
abstract:AIMS:To investigate the evolutionary origins of Australian healthcare-associated (HCA) methicillin-resistant Staphylococcus aureus (MRSA) strains from a panel of historical isolates typed using current genotyping techniques. METHODS:Nineteen MRSA isolates from 1965 to 1981 were examined and antibiotic susceptibility p...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1097/PAT.0b013e3283632667
更新日期:2013-08-01 00:00:00
abstract::Twelve thromboplastins were tested against a secondary reference thromboplastin (human brain CRM BCR No. 147) or a tertiary house standard (human brain thromboplastin) with plasmas from normal healthy individuals and patients on oral anticoagulant therapy. The relationship between the prothrombin ratios of the thrombo...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313029009063783
更新日期:1990-04-01 00:00:00
abstract::The coexistence of a pancreatic papillary cystic tumor with hairy cell leukemia is reported. To the best of our knowledge this association has never been published. A 41-year-old man diagnosed with hairy cell leukemia developed a second malignancy that corresponded to a papillary cystic pancreatic tumor. The patient u...
journal_title:Pathology
pub_type: 杂志文章
doi:
更新日期:2000-08-01 00:00:00
abstract::An enzyme-immunoassay has been developed for the detection of myoglobin in human serum and urine which is specific, accurate, precise, and has a sensitivity of 3 ng/ml. When compared with radioimmunoassay, the enzyme-immunoassay gives markedly similar results. Sera from normal adults had a myoglobin concentration in t...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313027909059049
更新日期:1979-10-01 00:00:00
abstract::Biochemical confirmation of the identity of Burkholderia pseudomallei in Singapore previously relied on the API 20NE panel of tests. After introducing an alternative proprietary biochemical panel, the Microbact 24E (MedVet, Adelaide, Australia), we noted that the API panel identified some presumptive B. pseudomallei i...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313029800169685
更新日期:1998-02-01 00:00:00
abstract::Micropapillary carcinoma of the colon and rectum is associated with an adverse prognosis. This tumour type displays reverse polarity of the tumour cells and is stated to be characterised by an inside-out epithelial membrane antigen (EMA)/MUC1 staining. Nine cases of primary colorectal carcinoma and one omental metasta...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1097/PAT.0000000000000144
更新日期:2014-10-01 00:00:00
abstract::An enzyme-immunoassay has been developed for rapid isotyping of murine monoclonal antibodies. This assay has several advantages over the commonly used typing methods. It does not require the presence of specific antigen. Typing plates can be prepared in advance and stored frozen. Unequivocal results can be obtained in...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028509063727
更新日期:1985-01-01 00:00:00
abstract::A cerebral neuroblastoma was studied by light microscopy, tissue culture and electron microscopy. Synapse-like structures were found within tumour cells. This supports the neuroectodermal origin of this neoplasm. ...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028009060082
更新日期:1980-04-01 00:00:00
abstract::Forty-six necropsy cases of recurrent pyogenic cholangitis (RPC) among Chinese in Hong Kong were reviewed. Intrahepatic biliary pigment stones or bile sludge were present in all cases and liver abscesses were common (80%). Histologically the early lesion was marked by acute inflammation in portal tracts with frequent ...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028009077105
更新日期:1980-07-01 00:00:00
abstract::An unusual case of gliomatosis cerebri in a 37 yr-old man is reported. He presented with a variable clinical picture. Mental changes, brain stem signs, cerebellar signs and rise in intracranial pressure were the constant findings. The postmortem findings are described and the available literature is reviewed. ...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028509063740
更新日期:1985-01-01 00:00:00
abstract::Recent updated models of the coagulation mechanism suggest that factor VII/thromboplastin complex is the main initiator or trigger of coagulation. Factor VII activation of factor IX is likely to be an important activation pathway. Inhibition of factor VII by tissue factor pathway inhibitor may have a regulatory role i...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313029700169954
更新日期:1997-05-01 00:00:00
abstract:AIM:Hepcidin, a recently identified peptide, acts as a central regulator of iron metabolism. It is regarded as a factor regulating the uptake of dietary iron and its mobilisation from macrophages and hepatic stores. It is considered as a mediator of anaemia of inflammation. The aim of this study was to assess whether s...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313020802436840
更新日期:2009-02-01 00:00:00
abstract::A study of 103 fetal adrenals obtained from stillborn fetuses and those dying in the neonatal period was performed to assess the significance of definitive cortex cystic change, compact cell change and lipid patterns, and their relationship to other pathological processes. The findings confirm that these changes are m...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028409068543
更新日期:1984-07-01 00:00:00
abstract::Exfoliative, abrasive and aspiration cytology were increasingly relied upon for tissue diagnosis of tumours. The established histological stains for the differentiation of mucin and non-mucin-secreting tumours are not ideal for alcohol-fixed cytology smears and a more reliable cytological technique for the preservatio...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313028309083509
更新日期:1983-07-01 00:00:00
abstract::One hundred and two cases of benign nerve sheath tumors (NSTs) were studied with a combined approach using routine light microscopy (LM), immunohistochemistry (IH) for myelin basic protein (MBP) and S-100 protein as well as transmission electron microscopy (TEM) with the aim of obtaining greater insight into the true ...
journal_title:Pathology
pub_type: 杂志文章
doi:10.3109/00313029009086659
更新日期:1990-10-01 00:00:00
abstract:AIMS:Twenty-six cases of granulomatous mastitis were examined to determine the common histological and clinical features and the possible association with micro-organisms. METHODS:A retrospective review of the clinical and histological features of these cases was undertaken, including granuloma, inflammatory cell infi...
journal_title:Pathology
pub_type: 杂志文章,评审
doi:10.1080/00313020410001692602
更新日期:2004-06-01 00:00:00
abstract::Ebolaviruses, and the other viral causes of haemorrhagic fevers (VHF) have always posed special problems for diagnostic laboratories. These arise from the rarity of human infections, minimal documented experience with test delivery and interpretation, the paucity of established commercial or in-house assays, the lack ...
journal_title:Pathology
pub_type: 杂志文章,评审
doi:10.1097/PAT.0000000000000292
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:Ethanol is teratogenic, interferes with folic acid and is extensively used by young women. Our objective was to determine the effects of ethanol and/or folate deficiency on mouse fetuses. METHOD:In Experiment 1, pregnant mice receiving a commercial diet were divided into three groups: control (C), low eth...
journal_title:Pathology
pub_type: 杂志文章
doi:10.1080/00313020701449290
更新日期:2007-10-01 00:00:00