In acute rheumatic carditis, the pathognomonic histological finding in the myocardium is:
- A Aschoff body — a granuloma with fibrinoid necrosis surrounded by Anitschkow cells (caterpillar cells) ✓
- B Caseating granuloma with Langhans giant cells
- C Neutrophilic microabscesses
- D Eosinophilic infiltration with charcot-Leyden crystals
Correct answer: A. Aschoff body — a granuloma with fibrinoid necrosis surrounded by Anitschkow cells (caterpillar cells)
Explanation
Aschoff bodies are the hallmark of rheumatic carditis. These myocardial granulomas consist of a central zone of fibrinoid necrosis surrounded by Anitschkow cells (macrophages with a distinctive caterpillar-shaped nucleus due to central chromatin condensation), lymphocytes, and plasma cells. Aschoff bodies may persist for decades after the acute attack. They are not seen in other forms of myocarditis.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
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