title: Histopathological aspects of cardiac biopsy in pediatric patients with dilated cardiomyopathy.
abstract: BACKGROUND
  Dilated cardiomyopathy (DCM) is a heart muscle disease with cardiac dysfunction and a heterogeneous disorder. This disease may show various histopathological aspects of the myocardium, but little is known about these in children.
  
  
  METHODS
  Histopathological findings of endomyocardial biopsy from 20 pediatric patients with DCM were analyzed and compared with those in adult patients.
  
  
  RESULTS
  Advanced histopathology, including myocytolysis and/or fragmentation of muscle bundles, was frequently observed in patients with poor prognosis. Patchy fibrosis was predominantly demonstrated in the pediatric patients, whereas perivascular fibrosis was mostly observed in the older adults. The myocarditic index, assessed in terms of the findings of fibrosis, size variation of myocytes, disarrangement of muscle bundles and mononuclear cell infiltration was higher in the pediatric patients than in the older adults (P < 0.05). Bizarre myocardial hypertrophy with disorganization, which tends to be frequently demonstrated in hypertrophic cardiomyopathy, was revealed in 30% of the pediatric patients, whereas it was disclosed in none of the older adult patients (P < 0.05).
  
  
  CONCLUSIONS
  These results suggest that the major pathogenetic factors of DCM in children may be different from those in adults.
authors.affiliation: Department of Surgical Pathology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan. nisikawa@clabo.twmu.ac.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Nishikawa
authors.forename: Kenta
authors.initials: K
authors.lastname: Uto
authors.forename: Saeko
authors.initials: S
authors.lastname: Kanai
authors.forename: Hideaki
authors.initials: H
authors.lastname: Oda
authors.forename: Shunji
authors.initials: S
authors.lastname: Kawamura
authors.forename: Toshio
authors.initials: T
authors.lastname: Nakanishi
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Morimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000473:pathology*; D001706:Biopsy / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011379:Prognosis; D012720:Severity of Illness Index; D055815:Young Adult