J Cardiovasc Ultrasound.  2010 Jun;18(2):66-69. 10.4250/jcu.2010.18.2.66.

Papillary Fibroelastoma Presenting as a Left Ventricular Mass

• Park JH
• Seol SH
• Cho HJ
• Park SH
• Kim DK
• Kim U
• Yang TH
• Kim DK
• Kim DI
• Kim DS

• KMID: 2135442
• DOI: http://doi.org/10.4250/jcu.2010.18.2.66

Abstract

Cardiac papillary fibroelastoma (CPF) is a benign cardiac tumor that usually affects cardiac valves. It is usually discovered incidentally on routine echocardiography. However, left ventricular CPF is rare. This report describes the case of a 73-year-old female, referred to a cardiology department for evaluation of a mass of the left ventricle. The mass was found routine echocardiography. The transthoracic echocardiography revealed a 2.2x1.3 cm highly oscillating mass, attached by stalk on the inferior wall of the left ventricle. Cardiac magnetic resonance imaging demonstrated a non-enhanced, 1.8x1.0 cm mass on the inferior wall of the left ventricle. The patient underwent surgical resection of the mass, histopathologic examination of the mass confirmed the diagnosis of a CPF.

Keyword

Cardiac tumor; Left ventricle; Echocardiography

MeSH Terms

Aged
Cardiology
Echocardiography
Female
Heart Neoplasms
Heart Valves
Heart Ventricles
Humans
Magnetic Resonance Imaging

Figure

• 

  Fig. 1 Transthoracic echocardiography reveals an oval shaped mass (2.2×1.3 cm) attached by stalk on the inferior wall of left ventricle (arrow).

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  Fig. 2 Transesophageal echocardiography reveals an oval shaped echogenic mass (1.7×1.0 cm) attached by stalk on the inferior wall of left ventricle with area of echo-lucency (arrow).

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  Fig. 3 Cardiac magnetic resonance imaging shows a non-enhanced, 1.8×1.0 cm mass with a stalk on the inferior wall of the left ventricle (arrow).

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  Fig. 4 Microscopic images show narrow, elongated and branching papillary fronds (H&E stain ×12.5) (A). Central avascular collagen and variable elastic tissue surrounded by acid mucopolysaccharide and lined by hyperplastic endothelial cells (H&E stain ×100) (B). Elastic fiber staining shows black colored core of papilla (elastc fiber stain ×12.5) (C). CD34 (endothelial cell marker) staining shows endothelial cell stained with brown color (CD34 stain ×200) (D).

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