The heart is small, possibly that of a child. The pericardium is markedly thickened and the
atrio-ventricular sulcus largely obliterated. While in a few areas there are fine strands of fibrin, in
other parts the strands are thicker and in some areas the surface is quite smooth. The appearances
point to a pericarditis of long standing. This is supported by the histological appearances which
show organising granulation tissue with fibrin on the surface and a patchy chronic inflammatory
infiltrate in the underlying fat.