A 16-year-old girl comes to the hospital with chest pain and respiratory distress. On physical examination, the patient is sho of breath, wheezing and gasping for air. A prominent pansystolic hea murmur and a prominent third hea sound are heard on cardiac auscultation. An X-ray study of the chest shows marked enlargement of the hea. The patient expires despite intense suppoive measures. At autopsy, microscopic examination of the myocardium discloses aggregates of mononuclear cells arranged around centrally located deposits of eosinophilic collagen. What is the appropriate diagnosis?
Focal inflammatory lesions are found in various tissues in patients with acute rheumatic fever. These inflammatory lesions are most distinctive within the hea, where they are termed "Aschoff bodies." They consist of foci of eosinophilic material surrounded by T lymphocytes, occasional plasma cells and plump macrophages called "Anitschkow cells." These distinctive cells have abundant cytoplasm and central round-to-ovoid nuclei, in which the chromatin is disposed in a central, slender, wavy ribbon(caterpillar cells). These lesions are pathognomonic for rheumatic fever and are not encountered in the other choices. Aschoff nodule
Acute bacterial endocarditis
Rheumatic hea disease
Subacute bacterial endocarditis
Viral myocarditis
Rheumatic Fever