ABSTRACT
Heart is encased by the pericardium which has a visceral layer closely opposed to the heart and the parietal layer. In normal states it is thin, transparent and the myocardium can be seen through it. It shows a lining of flattened to cuboidal mesothelial cells. A great deal of difficulty can be encountered in distinguishing reactive mesothelial cell from cells shed from a mesothelioma and carcinoma. A final diagnosis in most of the cases rests on a combined evaluation of histological, histochemical and immunocyto-chemical findings in addition to clinical features of the thickened pericardium. Serous effusion is accumulation of clear or straw colored fluid in the pericardial cavity. Common causes include congestive heart failure, and hypoproteinemia. Myxedema, rheumatic fever, systemic lupus erythematosis are some of the other causes. Granulomatous inflammation with areas of necrosis is seen. The granulomas are bordered by chronic inflammation.
