J Cardiovasc Ultrasound.  2014 Mar;22(1):40-42. 10.4250/jcu.2014.22.1.40.

Multiple Papillary Fibroelastomas and Thrombus in the Left Heart

• Seo GW
• Seol SH
• Park BM
• Kim TJ
• Kim JK
• Song PS
• Kim DK
• Kim KH
• Kim YM
• Kim DI

• KMID: 2177456
• DOI: http://doi.org/10.4250/jcu.2014.22.1.40

Abstract

Cardiac papillary fibroelastomas (CPF) are benign cardiac tumors and usually discovered incidentally during echocardiography. This report describes the case of a 68-year-old man, referred to cardiology for multiple masses of the left ventricle and left atrium. The transthoracic echocardiography revealed multiple oscillating masses in the left ventricle and aortic valve, non-mobile mass in the left atrium with severe mitral stenosis and moderate aortic regurgitation. The patient underwent surgical resection of the masses with valve replacements. Histopathologic examination confirmed the diagnosis of CPF in the left ventricle and aortic valve, thrombus in the left atrium.

Keyword

Cardiac papillary fibroelastomas; Cardiac tumor; Left atrial thrombus; Echocardiography; Cardiac magnetic resonance imaging

MeSH Terms

Aged
Aortic Valve
Aortic Valve Insufficiency
Cardiology
Diagnosis
Echocardiography
Heart Atria
Heart Neoplasms
Heart Ventricles
Heart*
Humans
Mitral Valve Stenosis
Thrombosis*

Figure

• 

  Fig. 1 Small oval shaped masses seen in parasternal long axis view (A, arrows), parasternal short axis view (B, arrows), showing heterogeneous echogeneicity with some internal echolucency.

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  Fig. 2 Cardiac magnetic resonance imaging demonstrated non-enhanced masses in left atrium (A, arrow) between the orifice of the right superior and inferior pulmonary vein, and in left ventricle (B, arrow) showing heterogeneous signal intensity in T2 image.

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  Fig. 3 Gross specimen of 1:1 paraffin block (H&E stain, × 10) (A) reveals central stalk with papillary projection. Histological examination of the resected tumor showing papillary projection. The tumor surface is covered by a single layer of endocardial cells with an overlying thin layer of an underlying acellular stroma composed of elastic fibers and collagen (H&E stain, × 40) (B).

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