Question

An 80-year-old woman was found dead in her room in a nursing home. Autopsy was carried out, and her death was reported as being secondary to old age. At autopsy, her heart was small (250 g) and dark brown in color on section. Microscopically, there was a light brown perinuclear pigment seen after hematoxylin and eosin (H&E) staining of the cardiac muscle fibers. Which of the following substances is most likely to be increased in the myocardial fibers to produce this cardiac appearance?

Option 1: Lipofuscin.
Option 2: Amyloid.
Option 3: Hemosiderin.
Option 4: Bilirubin.

Answer 1

The substance most likely increased in the myocardial fibers of the deceased 80-year-old woman's heart, giving it a brown appearance, is lipofuscin, a byproduct of cellular aging. Therefore, the correct option is 1.

Step-by-step explanation:

The dark brown heart with light brown perinuclear pigment seen in the cardiac muscle fibers of an 80-year-old woman likely indicates the presence of lipofuscin. This is a pigment that accumulates as a byproduct of cellular aging, and it is commonly found in the myocardial fibers of the elderly. In contrast, amyloid would be associated with amyloidosis and has a different staining characteristic. Hemosiderin accumulation occurs with iron overload, and would not typically present as a light brown pigment. Bilirubin is associated with jaundice and does not accumulate in the myocardial fibers in this manner.