title: Sudden unexpected death due to severe pulmonary and cardiac sarcoidosis.
abstract: In this paper we report the autopsy findings of a 57 year old woman who died unexpectedly at home. She had been complaining of shortness of breath, episodes of dry coughing, and nausea. Her past medical and social history was unremarkable. She had no previous history of any viral or bacterial disease and no history of oncological disorders. Autopsy revealed multiple grayish-white nodular lesions in the pleura and epicardial fat and areas resembling fibrosis on the cut surface of the anterior and posterior wall of the left ventricle and interventricular septum. Histological examination of the lungs and heart revealed multiple well-formed noncaseating epithelioid cell granulomas with multinucleated giant cells. Death was attributed to myocardial ischemia due to vasculitis of intramural coronary artery branches associated with sarcoidosis. Sarcoidosis is a multisystemic disease of unknown etiology characterized by the formation of noncaseating epithelioid cell granulomas in the affected organs and tissues. The diagnosis of sarcoidosis in this case was established when other causes of granulomatous disease such as tuberculosis, berylliosis, hypersensitivity pneumonitis, and giant cell myocarditis had been reasonably excluded.
authors.affiliation: Medico-Legal and Pathological-Anatomical Department of Health Care Surveillance Authority, Letná 47, 040 01, Kosice, Slovak Republic. e.ginelli@gmail.com.
authors.forename: Alžbeta
authors.initials: A
authors.lastname: Ginelliová
authors.affiliation: Medico-Legal and Pathological-Anatomical Department of Health Care Surveillance Authority, Letná 47, 040 01, Kosice, Slovak Republic.
authors.forename: Daniel
authors.initials: D
authors.lastname: Farkaš
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Pavol Jozef Šafárik University, Kosice, Slovak Republic.
authors.forename: Silvia
authors.initials: S
authors.lastname: Farkašová Iannaccone
authors.affiliation: Medico-Legal and Pathological-Anatomical Department of Health Care Surveillance Authority, Letná 47, 040 01, Kosice, Slovak Republic.
authors.forename: Vlasta
authors.initials: V
authors.lastname: Vyhnálková
mesh_terms: D001167:Arteritis / Q000209:etiology / Q000473:pathology; D009202:Cardiomyopathies / Q000150:complications* / Q000175:diagnosis; D003331:Coronary Vessels / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000209:etiology; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000175:diagnosis
keywords: Autopsy findings; Noncaseating granulomas; Pulmonary and cardiac sarcoidosis; Sudden death