Cardiac sarcoidosis, a cause of sudden cardiac death.

Freimane, K.Z.; Patel, K.; Griffin, K.J.

Cardiac sarcoidosis, a cause of sudden cardiac death.

All Authors

Freimane, K.Z.

Patel, K.

Griffin, K.J.

LTHT Author

Freimane, Katrina
Patel, Kenal
Griffin, Kathryn

LTHT Department

Pathology
Histopathology

Publication Date

2025

Item Type

Article In Press

Abstract

A 35-year-old white male with no medical history was found unresponsive. A postmortem examination revealed an enlarged heart showing left ventricular thickening and diffuse pale areas. Hilar lymphadenopathy was noted, and numerous white-tan nodules were present throughout the lungs and spleen, and, focally, in the liver. Postmortem toxicology testing revealed no significant findings. Histology demonstrated extensive non-caseating granulomas with multinucleated giant cells, asteroid bodies, Schaumann bodies and lymphocytic inflammation within the heart, lungs, spleen, lymph nodes and the liver. Sections of the heart also showed widespread fibrosis. A diagnosis of systemic sarcoidosis with cardiac involvement was offered, which likely lead to a fatal cardiac arrhythmia. This case highlights the importance of meticulous postmortem evaluation in suspected sudden cardiac deaths, as this will inform whether genetic testing for inherited cardiac conditions should be offered to the family of the deceased. A comprehensive work-up of a case with suspected sudden cardiac death should include histology, toxicology and consideration of the need to retain spleen for future genetic testing.