The pericardial cavity

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GROSS AND MICROSCOPIC DESCRIPTION

GROSS EXAMINATION   The body is that of a 64-year-old male. The body was opened by means of a midline incision showing the pleural and peritoneal cavities.  The organs were removed en toto by the Rokitansky method.

CARDIOVASCULAR SYSTEM:   The pericardial cavity contains a minimal amount of clear fluid. The heart appears enlarged and measures 13.0 x 10.0 x 8.0 cm and weighs 480.0 grams. Cut sections show a thickened left ventricular wall measuring 2.5cm, with a focus on a reddish area in the anterior ventricular wall, surrounded by white, firm tissues and cardiac muscles. Coronary arteries show evidence of calcification. Microsections show edema, hemorrhage, infiltrates of neutrophils, and mottling of the cardiac myocytes.  Other areas of show bands of fibrotic tissues traversing the cardiac myocytes. Coronary arteries are atherosclerotic.

RESPIRATORY SYSTEM:   The lungs are reddish black and spongy.   The right lung measures 22.0 x 11.0 x 8.5 and weighs 300.0 grams while the left lung measures 23.0 x 12.5 x 7.5 and weighs 275 grams. Cut sections show a moderate amount of mucoid material within the airway lumen. There are no gross masses noted. Microscopic sections of both lungs show carbon dust and hemosiderin-laden macrophages noted amidst pools of edema fluid, blood, and congested vascular channels. Dilated alveoli with damaged alveolar walls are also seen. No evidence of malignancy was noted.

LIVER:  The liver is enlarged, yellowish-brown, and smooth, measuring 27.0 cm x 24.5 cm x 14.0 cm and weighing 2100.0 grams.  Cut sections show a yellowish-brown, greasy surface. Microsections of the liver show sheets of hepatocytes arranged in single-cell thick plates separated by vascular sinusoids filled with red blood cells. These hepatocytes exhibit lipid vacuoles within the cytoplasm. There are patches of lymphocytic infiltrate and foci of hepatocellular necrosis around the central veins.

SPLEEN:   The spleen is fairly ovoid, bluish, doughy tissue measuring 11.0 cm x 10.0 cm x 4.0 cm and weighs 180 grams. Cut sections reveal a fairly solid reddish-brown cut surface. Microsections show the spleen shows well-delineated red pulp and white pulp with congested splenic cords filled with red cells.

PANCREAS: The pancreas presents as an elongated to ovoid, broad, tan to yellow tissue with a fairly smooth surface measuring 21.0 x 5.0 x 3.5 cms and weighing 115. grams. Cut sections show a yellowish-tan, lobulated surface. Microsection shows acinar glands in lobular architecture and is interrupted by islets of Langerhans. Vascular congestion is also seen.

KIDNEYS:   The right and left kidneys are covered by abundant perinephric fat and measure 10.7 x 5.0 x 3.5 cm, and 11.0 x 6.5 x 5.5 cm, respectively. Cut sections reveal reddish-brown solid parenchyma with a prominent cortico-medullary junction. The pelvicalyceal system is intact. Microsections of both kidneys and the pelvicalyceal system show essentially normal findings. Vascular congestion is also seen.

 

GASTROINTESTINAL SYSTEM:   The stomach measures 22.0 x 14.0 x 6.5 cm. The mucosa appears light tan with prominent rugal folds and contains brown fluid amounting to 150.0 ml. There is no ulceration or mass noted. The small intestine consists of a pinkish-tan light-tan tissue with smooth serosa. Likewise, the colon measures 220 x 8.0cm and shows unremarkable gross findings. The appendix is absent. Microsections of the gastrointestinal tract show intact mucosa with focal patches of lymphocytic infiltrates.