FORENSIC PATHOLOGY REVIEWS Volume 1 - Securimetric

160 Fineschi and Pomara
Fig. 14. Colliquative myocytolysis. Mild loss of myofibrils in a transverse
section producing an alveolar pattern (hematoxylin and eosin, original magnification
× 600).
myonecrosis mentioned above, the alveolar pattern lacks macrophages or any
other cell reaction. The impression is that of a colliquation or washout of myofibrils
that leaves a sarcolemmal sheath with a clear alveolar appearance with
a cytoplasm filled by edema and/or packed with small granules (mitochondria)
(Fig. 15).
Recently, we described a morphofunctional myocardial pattern linked
with ventricular fibrillation defined as “myofiber break-up.” Myofiber breakup
includes the following histological patterns: (a) bundles of myocardial cells
in distension alternated with hypercontracted ones. In the latter, widening or
rupture (segmentation) of the intercalated discs occurs. Myocardial nuclei in
the hypercontracted cells assume a “square” aspect rather than the ovoid morphology
seen in distended myocytes, (b) hypercontracted myocytes standing
in line that are alternated with hyperdistended ones, often divided by a widened
disk, and (c) noneosinophilic bands of hypercontracted sarcomeres alternated
with stretched, often apparently separated sarcomeres.
Each of the functional forms of myocardial damage described above has
a distinct structural and biochemical nature. In irreversible relaxation, intrac-