Cardiac Sarcoidosis in an Adult Male: An Autopsy Finding

Sarcoidosis is an inflammatory disease of unknown cause which results in the formation of non caseating granulomatous lesion. Lung and lymph nodes are most frequently involved, however any organ of the body can be affected. Although, it has been observed that approximately one fourth of cases of sarcoidosis develop cardiac involvement, only 5% show clinical manifestations and most cases are diagnosed in autopsy studies. Here, an uncommon case of cardiac sarcoidosis presented, diagnosed on autopsy. A 68-year-old male was brought dead to the hospital to conduct an autopsy. On dissection, in the coronal cut of the heart specimen, multiple small greyish white nodules were seen in left ventricular wall. Special stains like Ziehl Neelsen (ZN) stain for tubercular bacilli and Periodic Acid Schiff (PAS) stain and Grocott’s Methenamine Silver (GMS) stain for fungal aetiology were non contributory. Histopathological examination revealed multiple non caseating granulomas with numerous giant cells rimmed by few scattered lymphocytes along with areas of fibrosis. A diagnosis of granulomatous carditis-sarcoidosis was given. This case report highlights that in all cases revealing non caseating granulomatous inflammation negative for acid fast bacilli and fungus, sarcoidosis should be suspected.