Papillary fibroelastoma (PFE)
General: Benign. Second most common primary cardiac tumor, accounting for ~75% of all cardiac valvular tumors. May be asymptomatic, cause thromboembolism, or act as a mechanical valvular obstruction. Tumor mobility is an independent predictor of death or significant embolism. Excision is considered curative.
Gross: 0.2 to 7.0 cm excrescence, most common on the aortic valve, though may involve any heart valve. Classically look like a sea anemone when placed in water or saline.
Microscopic: Composed of fine avascular papillae lined by endothelium, and may branch. Cell of origin is unknown.
Differential Diagnosis:
Stains:
- Positive: Any elastic stain, highlights elastic components within papillae.
- Negative:
- Suggested, focused panel:
(Lefkowitch: AP Board Review)
Images:
Cases:
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