title: A case report of lethal post-viral lymphocytic myocarditis with exclusive location in the right ventricle.
abstract: The inflammatory involvement of vital organs may represent a dangerous and life-threatening situation: in particular, the inflammation of the myocardial tissue of the heart may lead to severe consequences since the clinical history of the disease may be completely asymptomatic, any clinical sign may be lacking, thus preventing correct diagnosis and treatment. This may occur even in the case of myocarditis and may lead to unexpected death whose cause can be assessable only by means of a thorough histopathological examination. The article reports the case of 61-year old female who developed a flu-like syndrome with very few symptoms, followed by sudden death in three weeks. The autopsy and following histopathological investigations identified the cause of death in a post-viral lymphocytic myocarditis, probably related to the previous infectious disease, and alternative causes (as arrhythmic ventricular dysplasia, vasculitis, sarcoidosis and giant cell myocarditis) were excluded. The exclusive location in the right ventricle was a peculiar finding. The case highlights the importance of the myocardium of the right ventricle, a tissue which is often less considered even in histopathological surveys. The exclusive location of myocarditis in the right ventricle is a rare event but in this case fully responsible for death.
authors.affiliation: Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
authors.forename: Graziano Domenico Luigi
authors.initials: GD
authors.lastname: Crudele
authors.affiliation: Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy. Electronic address: albertoamadasi@libero.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Amadasi
authors.affiliation: Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Marasciuolo
authors.affiliation: Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rancati
authors.affiliation: Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
authors.forename: Guendalina
authors.initials: G
authors.lastname: Gentile
authors.affiliation: Sezione di Medicina Legale e delle Assicurazioni, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Zoja
mesh_terms: D001344:Autopsy; D003645:Death, Sudden / Q000209:etiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis*; D014777:Virus Diseases / Q000150:complications
keywords: Forensic histopathology; Forensic pathology; Lymphocytic myocarditis; Right ventricle; Sudden death