心脏乳头状弹力纤维瘤2例临床病理观察
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摘要
目的探讨心脏乳头状弹力纤维瘤的临床病理特征、免疫组化、特殊染色及鉴别诊断。方法对2例心脏乳头状弹力纤维瘤进行组织学观察、免疫组化染色、弹力纤维染色和临床随访,并复习相关文献。结果 2例病理大体观察均呈灰白色、分叶乳头状,在固定液中类似"海葵样";组织学形态表现一致,均呈乳头状结构,中心为纤维样轴心,周围包绕黏液样基质,表面被覆内皮细胞。免疫组化:表面被覆细胞CD34、CD31和vimentin均(+),CK、CR、CD117和D2-40(-),其中1例S-100(+);弹力纤维染色均(+)。结论心脏乳头状弹力纤维瘤是一种罕见的心脏良性肿瘤,组织病理学特点结合免疫组化标记及特殊染色有助于该肿瘤的确诊。
Objective To study the clinical and pathological features of cardiac papillary fibroelastoma( PFE) which could facilitate the diagnosis. Methods There were 2 cases of PFE. We performed histological observation,immunohistochemical staining,elastic fiber staining with review of relevant literatures. Results Grossly,2 cases were all gray-white,lobular papilloma and similar to "sea anemone " in the fixed solution. The histological features were identical: the papillary core was fibrous axis,surrounded with mucoid matrix and covered with endothelial cells on surface.Immunohistochemically,the surface cladding cells were the positive of CD34,CD31,vimentin and negative of CK,CR,CD117,D2-40. The second case was positive of S-100. The elastin staining was positive. Connclusions Cardiac papillary fibroma is a rare primary heart disease. Its diagnosis can be establishied on the chanracteristic morphological features and immunohistochemical findings.
Objective To study the clinical and pathological features of cardiac papillary fibroelastoma( PFE) which could facilitate the diagnosis. Methods There were 2 cases of PFE. We performed histological observation,immunohistochemical staining,elastic fiber staining with review of relevant literatures. Results Grossly,2 cases were all gray-white,lobular papilloma and similar to "sea anemone " in the fixed solution. The histological features were identical: the papillary core was fibrous axis,surrounded with mucoid matrix and covered with endothelial cells on surface.Immunohistochemically,the surface cladding cells were the positive of CD34,CD31,vimentin and negative of CK,CR,CD117,D2-40. The second case was positive of S-100. The elastin staining was positive. Connclusions Cardiac papillary fibroma is a rare primary heart disease. Its diagnosis can be establishied on the chanracteristic morphological features and immunohistochemical findings.
引文
[1]刘建英,张真路.心脏乳头状弹力纤维瘤6例临床病理分析[J].临床肿瘤学杂志,2014,19(06):553-555.
[2]王泰龄.心血管系统疾病[A].刘彤华.诊断病理学[M].北京:人民卫生出版社,1994. 869-870.
[3]周庚寅,刘洪琪,张庆慧,主译.肿瘤组织病理诊断[M].山东:山东科学技术出版社,2001. 21-23.
[4]滕飞,陈东,方微,等. 10例心脏乳头状弹力纤维瘤临床病理分析[J].心肺血管病杂志,2015,34(08):640-642.
[5] Miller A,Perez A,Pabba S,et al. Aortic valve papillary fibroelastoma causing embolic strokes:a case report and review[J]. Int Med Case Rep J,2017,10:109-112.
[6] Abu Saleh WK,Al Jabbari O,Ramlawi B,et al. Cardiac papillary fibroelastoma:single-institution experience with 14 surgical patients.[J]. Tex Heart Inst J,2016,43(2):148-151.
[7] Mkalaluh S,Szczechowicz M,Torabi S,et al. Surgery for cardiac papillary fibroelastoma:a 12-year single institution experience[J]. Med Sci Monit Basic Res,2017,23:258-263.
[8] Sakata T,Nakaya M,Otsu M,et al. Autologous pericardial patch repair for papillary fibroelastoma on an aortic valve leaflet[J].Tex Heart Inst J,2017,44(2):144-146.
[9] Yandrapalli S,Mehta B,Mondal P,et al. Cardiac papillary fibroelastoma:the need for a timely diagnosis[J]. World J Clin Cases,2017,5(1):9-13.
[10] Bicer M,Cikirikcioglu M,Pektok E,et al. Papillary fibroelastoma of the left atrial wall:a case report[J]. J Cardiothorac Surg,2009,4:28.
[11]李小航.心脏黏液瘤的诊断与治疗[J].中国现代医药杂志,2011,13(5):131-132.
[12]于小华,吴波,石群立,等.主动脉瓣乳头状弹力纤维瘤1例报道并文献复习[J].诊断病理学杂志,2004,11(6):395-396.
[13] Perez-Downes J, Dietzius H,Ibrahim S,et al. Atypical presentation of a ventricular papillary fibroelastoma[J]. J Geriatr Cardiol,2017,14(8):534-535.
[14]刘建英,张真路.心脏黏液瘤149例临床及病理分析[J].临床与实验病理学杂志,2013,29(06):680-682.
[15]张明,王勇,吴奇勇,等.主动脉瓣乳头状弹力纤维瘤并发冠心病一例报道并文献复习[J].心血管外科杂志(电子版),2016,5(03):142-144.
[2]王泰龄.心血管系统疾病[A].刘彤华.诊断病理学[M].北京:人民卫生出版社,1994. 869-870.
[3]周庚寅,刘洪琪,张庆慧,主译.肿瘤组织病理诊断[M].山东:山东科学技术出版社,2001. 21-23.
[4]滕飞,陈东,方微,等. 10例心脏乳头状弹力纤维瘤临床病理分析[J].心肺血管病杂志,2015,34(08):640-642.
[5] Miller A,Perez A,Pabba S,et al. Aortic valve papillary fibroelastoma causing embolic strokes:a case report and review[J]. Int Med Case Rep J,2017,10:109-112.
[6] Abu Saleh WK,Al Jabbari O,Ramlawi B,et al. Cardiac papillary fibroelastoma:single-institution experience with 14 surgical patients.[J]. Tex Heart Inst J,2016,43(2):148-151.
[7] Mkalaluh S,Szczechowicz M,Torabi S,et al. Surgery for cardiac papillary fibroelastoma:a 12-year single institution experience[J]. Med Sci Monit Basic Res,2017,23:258-263.
[8] Sakata T,Nakaya M,Otsu M,et al. Autologous pericardial patch repair for papillary fibroelastoma on an aortic valve leaflet[J].Tex Heart Inst J,2017,44(2):144-146.
[9] Yandrapalli S,Mehta B,Mondal P,et al. Cardiac papillary fibroelastoma:the need for a timely diagnosis[J]. World J Clin Cases,2017,5(1):9-13.
[10] Bicer M,Cikirikcioglu M,Pektok E,et al. Papillary fibroelastoma of the left atrial wall:a case report[J]. J Cardiothorac Surg,2009,4:28.
[11]李小航.心脏黏液瘤的诊断与治疗[J].中国现代医药杂志,2011,13(5):131-132.
[12]于小华,吴波,石群立,等.主动脉瓣乳头状弹力纤维瘤1例报道并文献复习[J].诊断病理学杂志,2004,11(6):395-396.
[13] Perez-Downes J, Dietzius H,Ibrahim S,et al. Atypical presentation of a ventricular papillary fibroelastoma[J]. J Geriatr Cardiol,2017,14(8):534-535.
[14]刘建英,张真路.心脏黏液瘤149例临床及病理分析[J].临床与实验病理学杂志,2013,29(06):680-682.
[15]张明,王勇,吴奇勇,等.主动脉瓣乳头状弹力纤维瘤并发冠心病一例报道并文献复习[J].心血管外科杂志(电子版),2016,5(03):142-144.