An autopsy case report of 60 year old female patient who died suddenly after getting in minor altercation with neighbors. An autopsy was conducted and the heart was sent for histopathological examination. Histopathological examination revealed presence of multinucleated giant cells, lymphocytes, neutrophils, plasma cells and macrophages around areas of necrotic zone with absence of granulomas. No previous history of tuberculosis was known. The present case highlights the giant cell myocarditis as a rare fatal diagnosis made on autopsy. Introduction Giant cell myocarditis is rare morphologically distinct form of myocarditis with a very fulminant and fatal course. [1,2]This disease lacks granuloma formation and is now considered to be a separate entity from granulomatous myocarditis. Etiology of giant cell Myocarditis is unknown till date however in some patients there is an association with autoimmune diseases like rheumatic disease, myasthenia gravis, thymoma, systemic lupus erythematous, thyroiditis, dermatomyositis, pernicious anemia and ulcerative colitis. The purpose of this case report is to highlight a very rare diagnosis which has fatal outcome and is diagnosed incidentally on autopsy.. Case report A 60 year old female patient collapsed suddenly after getting in a minor altercation with neighbors. A medico legal autopsy was conducted and the heart was sent for histopathological examination. There was no external injury and patient was moderately built and nourished with no previous history of any kind of major ailment. The cause of death was ascertained only on autopsy and histopathological examination of heart. On gross examination of the heart it weighed 420 gms. Both ventricles were normal and the left ventricular wall thickness was 1.6 cms and right ventricular wall thickness is 0.8 cms . multiple irregular grayish white areas were noted on both ventricular walls . Papillary muscles , chordae tendinae, atria, orifices, ostia and valves were normal. Coronaries were patent [Figure 1].
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