TEM of formalin-fixed, paraffin-embedded lung from KD patient 1.

<p>A, ciliated bronchial epithelium demonstrating electron-dense apical ICI (block arrows). B, alveolar macrophage, demonstrating perinuclear, finely granular spheroid bodies similar to those seen within the bronchial epithelium (block arrow). N = nucleus, C = cilia. A = 9,500X, B = 26,000X.</p

Controls and the pathologic findings in their lungs.

<p>NA = not available, COPD = chronic obstructive pulmonary disease, SLE = systemic lupus erythematosis, IHC = +indicates staining with antibody J but not antibody I,-indicates negative results with I and J</p

Peribronchial lymph node from KD patient 2.

<p>A, IHC using synthetic antibody J, showing antigen-positive macrophages containing spheroid bodies (arrows); B, transmission electron microscopy (TEM) of macrophage, showing two large, finely granular ICI (arrows). A = 40X, B = 20,000X.</p

Patients with a history of Kawasaki Disease (KD) and the pathologic findings in their lungs.

<p>NA = not available, ND = not done, PE = pulmonary emboli, ARDS = acute respiratory distress syndrome, IHC = +indicates staining with antibody J but not antibody I,-indicates negative results with I and J</p

Myocarditis.

<p>A. Low magnification H&E of a poorly-preserved hourglass-shaped epicardial CA showing varying degrees of SA/C peri-arteritis, transmural SA/C, and minimal preserved media. H&E, case 1, original magnification 10×. B. Perivascular and transmural SA/C inflamed adventitia and heavily damaged media with some discernible SMC and IEL, and SA/C-LMP with scattered pleomorphic myofibroblasts. There are some eosinophils intermixed with the small lymphocytes. H&E, case 1, original magnification 16×. C. A higher magnification of a typical area of SA/C-LMP with prominent amphophilic myofibroblasts in a background of mostly small lymphocytes, scattered eosinophils, and likely macrophages in a fibrillar ECM that shows some artifactual spaces. H&E, case 1, original magnification 25×. D. A typical area of the highly edematous interstitial myocarditis especially rich in eosinophils, with scattered lymphocytes, macrophages, and plasma cells. Note the longitudinally-sectioned caterpillar-shaped and cross-sectioned, owl eye-shaped (unidentified) Anitschkow chromatin pattern in a myocyte and two unidentified cell nuclei, respectively. H&E, case 1, original magnification 40×. L=lumen, NV=nerve, IEL=internal elastic lamina, Eo=eosinophil, AM=Anitschkow myocyte, MF=myofibroblast, V=vein, ADV=adventitia, M=media.</p

Increase in myofibroblast RER and pleomorphism, as well as intercellular elastin.

<p><b>A</b>) The actin (A)/dense bodies (long red arrows) share the cytoplasm with RER. The extracellular matrix is composed almost exclusively of haphazardly arranged electron dense banded collagen. The ECM obscures the dense plaques and external lamina. Pinocytic vesicles (P) are visible. Case 32, original magnification 5,000×. <b>B</b>) Dense plaques (short black arrows), actin (A), and dense bodies (long red arrows) have decreased and there is more RER. Note the abundant electron dense intercellular elastin (E), mixed with the collagen. Note the external lamina (long black arrows). Case 32, original magnification 5,000×.</p

Newly described pathologic features observed in the 41 KD patients.

<p>Newly described pathologic features observed in the 41 KD patients.</p

Pathologic findings in patients with Kawasaki Disease.

<p>RCIA=right common iliac artery, SA/C=subacute/chronic inflammation, CA=coronary artery, CAA=coronary artery aneurysm, LMP=luminal myofibroblastic proliferation, MI=myocardial infarction, TX=transplant, Mac=macrophage, SI=small intestine, RCA=right coronary artery, LAD=left anterior descending artery, LCx=left circumflex artery, IMA=inferior mesenteric artery, GB=gallbladder, MV=mitral valve, TV=tricuspid valve, PV=pulmonary valve, GT=granulation tissue, eos=eosinophils, SMA=superior mesenteric artery, PA=pulmonary arteries, macs=macrophages, PMNL=predominantly neutrophils, U=unknown, N/A=not available, EFE=endocardial fibroelastosis, ECMO=extracorporeal membrane oxygenation, IVC=inferior vena cava. Notes: CA sections usually contained myocardium, epicardium, and some endocardium. All patients had active SA/C plus LMP in coronary and also in available non-coronary arteries. Varying degrees of chronic hypoxia (hydropic change) seen in all cases. Anitschkow cells always seen, if case had at least two sections of myocardium. EFE always seen, if specimens included more than focal endocardium. By report=slides not available, but description sufficient to derive pathology.</p