In acute rheumatic fever, Aschoff bodies are pathognomonic cardiac lesions. The cells at the center of these granulomatous lesions are Anitschkow cells ('caterpillar cells'). Anitschkow cells are best described as:
- A Activated macrophages with chromatin condensed into a slender wavy ('owl eye' from end-on) central ribbon surrounded by abundant pale cytoplasm ✓
- B Activated eosinophils with bilobed nuclei
- C Reed-Sternberg cells representing reactive lymphocytes
- D Plasma cells secreting anti-streptococcal antibodies
Explanation
Anitschkow myocytes (also called 'caterpillar cells') are the pathognomonic cell of Aschoff bodies. They are activated macrophages with a distinctive nucleus in which chromatin condenses into a central, thin, wavy ribbon — viewed en face this appears as an 'owl eye.' When viewed longitudinally the ribbon resembles a caterpillar, giving the cell its descriptive name. These cells represent the primary cellular response in rheumatic myocarditis and are surrounded by lymphocytes, plasma cells, and occasional giant cells (Aschoff giant cells). Finding Aschoff bodies at autopsy or biopsy confirms rheumatic carditis.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.