GPR: 2019 - Week 49

From MGH Learn Pathology

Clinical history

71 year old female with a history of cerebral infarction and remote breast cancer. A cardiac mass was identified at autopsy.


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Papillary fibroelastoma
- Most common primary neoplasm of cardiac valves

- Papillary structure with mobile fronds

- May have calcification or adherent thrombus

- May occur after cardiac procedures or instrumentation
 

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Cardiac myxoma

- Most common primary cardiac neoplasm

- 3rd to 6th decade - Most commonly atrial, left sided, often near the fossa ovalis

- Rarely on valve leaflets or cusps

- Heterogeneous, with soft, gelatinous or friable texture, and may contain calcification or hemorrhage

- Pedunculated or sessile, smooth or papillary
 

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Nonbacterial thrombotic endocarditis

- Vegetations composed of fibrin and platelets

- Associated with neoplasms, autoimmune conditions, and valvular diseases

- Commonly incidental, usually in 4-8th decades

- Most commonly on mitral and aortic valves

- Verrucous, either firmly attached or friable

- Most are <1 cm, broad based and irregular
 


Dr. Abner Louissaint

Dr. Diane Brackett

Emma Thompson
Maleszewski JJ. Cardiac Myxoma. ExpertPath. https://app.expertpath.com/document/cardiac-myxoma/515f6d36-ae52-4623-a422-b49daac1b177?searchTerm=cardiac myxoma. Accessed October 15, 2019.

Maleszewski JJ. Papillary Fibroelastoma. ExpertPath. https://app.expertpath.com/document/papillary-fibroelastoma/36c1bf22-4884-4e7a-bb02-18e6bd843bae?searchTerm=papillary fibroelastoma. Accessed October 15, 2019.

Nair V., Revelo MP., Nonbacterial Thrombotic Endocarditis. ExpertPath. https://app.expertpath.com/document/nonbacterial-thrombotic-endocardit-. Accessed November 30, 2019.

This week's Gross Pathology Roundup was presented by Caroline Hilburn, MD on Mon, Dec 02, 2019.