{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T09:37:46Z","timestamp":1792575466926,"version":"4.5.0"},"reference-count":24,"publisher":"Archives of Pathology and Laboratory Medicine","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context.\u2014<\/jats:title>\n                    <jats:p>Cardiac complications of immune checkpoint inhibitor therapy are rare, but reports of myocarditis are increasing. The findings have been described in case reports as lymphocytic myocarditis, but its histopathology is underreported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective.\u2014<\/jats:title>\n                    <jats:p>To review the histology of myocardial biopsy\u2013proven cases of immune checkpoint\u2013associated myocarditis and provide immunohistochemical characterization of the inflammatory infiltrate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design.\u2014<\/jats:title>\n                    <jats:p>We have encountered 6 patients with biopsy-proven myocarditis in conjunction with therapy using anti\u2013programmed death receptor-1 (PD-1)\/programmed death ligand-1 (PD-L1) agents with and without cytotoxic T-lymphocyte associated protein 4 (CTLA-4) inhibitors and characterized the histopathology and immune cell profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.\u2014<\/jats:title>\n                    <jats:p>The myocarditis was multifocal\/diffuse and characterized by a predominant CD163-positive histiocytic infiltrate, with an associated CD8+ and PD-1+ T-lymphocytic infiltrate, some of which were granzyme B positive. Cardiac myocytes showed immunoreactivity for PD-L1 in areas of injury, confirmed using 2 different anti\u2013PD-L1 clones. Four of 6 patients recovered from their cardiac injury. One patient had residual tachycardia-bradycardia syndrome and 1 patient expired.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.\u2014<\/jats:title>\n                    <jats:p>The diffuse lymphohistiocytic myocarditis associated with this therapy is relatively distinctive, and this diagnosis is strongly suggested based on the histopathologic findings in the correct clinical setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5858\/arpa.2019-0447-oa","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T15:24:31Z","timestamp":1583767471000},"page":"1392-1396","source":"Crossref","is-referenced-by-count":58,"title":["Histopathologic Characterization of Myocarditis Associated With Immune Checkpoint Inhibitor Therapy"],"prefix":"10.5858","volume":"144","author":[{"given":"Irina","family":"Sobol","sequence":"first","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Weill Cornell Medicine, New York, New York (Sobol, Mahmood)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol L.","family":"Chen","sequence":"additional","affiliation":[{"name":"the Department of Medicine, Division of Cardiology, Memorial Sloan Kettering Cancer Center, New York, New York (Chen)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed S.","family":"Mahmood","sequence":"additional","affiliation":[{"name":"From the Department of Medicine, Division of Cardiology, Weill Cornell Medicine, New York, New York (Sobol, Mahmood)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain C.","family":"Borczuk","sequence":"additional","affiliation":[{"name":"and Weill Cornell Pathology, New York, New York (Borczuk)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3906","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"2020102620022031800_i1543-2165-144-11-1392-b01","doi-asserted-by":"crossref","unstructured":"Salem\n              JE,\n            \n            \n              Manouchehri\n              A,\n            \n            \n              Moey\n              M,\n            \n            et al.\n\t\t\t\t\t\n          Cardiovascular toxicities associated with immune checkpoint inhibitors: an observational, retrospective, pharmacovigilance study.\n\t\t\t\t\tLancet Oncol.\n\t\t\t\t\t2018;\n\t\t\t\t\t19(12):\n\t\t\t\t\t1579\u2013\n\t\t\t\t\t1589.","DOI":"10.1016\/S1470-2045(18)30608-9"},{"key":"2020102620022031800_i1543-2165-144-11-1392-b02","doi-asserted-by":"crossref","unstructured":"Aretz\n              HT.\n            \n          \n          Myocarditis: the Dallas criteria.\n\t\t\t\t\tHum 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Rep.\n\t\t\t\t\t2018;\n\t\t\t\t\t25:\n\t\t\t\t\t74\u2013\n\t\t\t\t\t77.","DOI":"10.1016\/j.gore.2018.05.014"},{"key":"2020102620022031800_i1543-2165-144-11-1392-b19","doi-asserted-by":"crossref","unstructured":"Moslehi\n              JJ,\n            \n            \n              Salem\n              JE,\n            \n            \n              Sosman\n              JA,\n            \n            \n              Lebrun-Vignes\n              B,\n            \n            \n              Johnson\n              DB.\n            \n          \n          Increased reporting of fatal immune checkpoint inhibitor-associated myocarditis.\n\t\t\t\t\tLancet.\n\t\t\t\t\t2018;\n\t\t\t\t\t391(10124):\n\t\t\t\t\t933.","DOI":"10.1016\/S0140-6736(18)30533-6"},{"key":"2020102620022031800_i1543-2165-144-11-1392-b20","doi-asserted-by":"crossref","unstructured":"Mahmood\n              SS,\n            \n            \n              Fradley\n              MG,\n            \n            \n              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