PAPILLARY FIBROELASTOMA Figure 15-17 PAPILLARY FIBROELASTOMA Papillary fibroelastomas may occur on damaged endocardial surfaces in hypertrophic cardiomyopathy, such as on valves or on the left ventricular outflow tract, particularly following surgical myectomy procedures. More about this image found in PAPILLARY FIBROELASTOMA Papillary fibroelastomas may occur on damaged endo...

PAPILLARY FIBROELASTOMA: ECHOCARDIOGRAPHIC FEATURES Figure 40-1 PAPILLARY FIBROELASTOMA: ECHOCARDIOGRAPHIC FEATURES Left: A small aortic valve papillary fibroelastoma (PFE) (yellow arrow) with a shimmering edge. Right: Seen in profile, the stalk of the PFE and the fronds are in view. More about this image found in PAPILLARY FIBROELASTOMA: ECHOCARDIOGRAPHIC FEATURES Left: A small aortic v...

PAPILLARY FIBROELASTOMA Figure 40-8 PAPILLARY FIBROELASTOMA Delicate, arborizing, fronds with central attachment. More about this image found in PAPILLARY FIBROELASTOMA Delicate, arborizing, fronds with central attachme...

PAPILLARY FIBROELASTOMA Figure 40-2 PAPILLARY FIBROELASTOMA Numerous papillary fronds impart a “sea anemone”-like quality to the tumor. More about this image found in PAPILLARY FIBROELASTOMA Numerous papillary fronds impart a “sea anemone”-l...

PAPILLARY FIBROELASTOMA: ELASTIC TISSUE Figure 40-9 PAPILLARY FIBROELASTOMA: ELASTIC TISSUE The elastic layers, highlighted with an elastic stain, are granular, somewhat mimicking a tendinous cord. More about this image found in PAPILLARY FIBROELASTOMA: ELASTIC TISSUE The elastic layers, highlighted wi...

PAPILLARY FIBROELASTOMA: UNUSUAL LOCATIONS Figure 40-5 PAPILLARY FIBROELASTOMA: UNUSUAL LOCATIONS Left: PFE (yellow arrow) arising on a Chiari network. Right: PFE (yellow arrow) arising on the submitral valve endocardium. More about this image found in PAPILLARY FIBROELASTOMA: UNUSUAL LOCATIONS Left: PFE (yellow arrow) arisin...

MULTIPLE PAPILLARY FIBROELASTOMAS Figure 40-7 MULTIPLE PAPILLARY FIBROELASTOMAS Multiple PFEs arising from the left ventricular outflow tract of a patient who had previously undergone subaortic septal myectomy for hypertrophic cardiomyopathy. More about this image found in MULTIPLE PAPILLARY FIBROELASTOMAS Multiple PFEs arising from the left vent...

PAPILLARY FIBROELASTOMA: FIBROSED TUMOR Figure 40-11 PAPILLARY FIBROELASTOMA: FIBROSED TUMOR When the fronds fibrose and fuse together, the tumor can lose its papillary appearance and mimic a thrombus or vegetation. An elastic stain highlights the remnant fronds. More about this image found in PAPILLARY FIBROELASTOMA: FIBROSED TUMOR When the fronds fibrose and fuse t...

PAPILLARY FIBROELASTOMA: SIZE AND MORPHOLOGIC SPECTRUM Figure 40-3 PAPILLARY FIBROELASTOMA: SIZE AND MORPHOLOGIC SPECTRUM A,B: Small (A) and large (B) PFEs arising from stalks. C,D: Small (C) and large (D) PFEs without evident stalks. More about this image found in PAPILLARY FIBROELASTOMA: SIZE AND MORPHOLOGIC SPECTRUM A,B: Small (A) and ...

PAPILLARY FIBROELASTOMA: MYXOID APPEARANCE Figure 40-14 PAPILLARY FIBROELASTOMA: MYXOID APPEARANCE Left: The tumor can have a myxoid appearance grossly when not in solution, simulating a myxoma. Right: Placing the tumor in solution reveals its papillary nature (same specimen as left). More about this image found in PAPILLARY FIBROELASTOMA: MYXOID APPEARANCE Left: The tumor can have a myxo...

PAPILLARY FIBROELASTOMA: MATTED TYPE Figure 40-12 PAPILLARY FIBROELASTOMA: MATTED TYPE On H&E, a matted PFE may appear bland, somewhat homogeneous, and thrombus-like (left); however, elastic staining of the lesion highlights the underlying elastic fibers and papillary nature of the process (r... More about this image found in PAPILLARY FIBROELASTOMA: MATTED TYPE On H&E, a matted PFE may appear b...

PAPILLARY FIBROELASTOMAS: ARISING ON DAMAGED ENDOCARDIUM Figure 40-6 PAPILLARY FIBROELASTOMAS: ARISING ON DAMAGED ENDOCARDIUM These PFEs (yellow arrows) are arising on the tensor apparatus of a damaged anterior mitral valve leaflet secondary to chronic rheumatic mitral valve disease, evidenced by... More about this image found in PAPILLARY FIBROELASTOMAS: ARISING ON DAMAGED ENDOCARDIUM These PFEs (yello...

PAPILLARY FIBROELASTOMA AND LAMBL EXCRESCENCE (LE) Figure 40-13 PAPILLARY FIBROELASTOMA AND LAMBL EXCRESCENCE (LE) The PFE (yellow arrow) is typically larger and more complex with branching fronds, while a LE (yellow arrowhead) is simple, filiform, and without complex branching. LEs are also rest... More about this image found in PAPILLARY FIBROELASTOMA AND LAMBL EXCRESCENCE (LE) The PFE (yellow arrow) ...

PAPILLARY FIBROELASTOMA: FRONDS Figure 40-10 PAPILLARY FIBROELASTOMA: FRONDS A,B: The fronds are avascular and consist of collagen (A) (hematoxylin and eosin [H&E] stain) and granular elastin (elastic stain), which is variable from frond to frond (B). C,D: The surface is lined by a single la... More about this image found in PAPILLARY FIBROELASTOMA: FRONDS A,B: The fronds are avascular and consist ...

PAPILLARY FIBROELASTOMA Figure 40-4 PAPILLARY FIBROELASTOMA Left: PFE (yellow arrow) arising from the closing edge of the anterior mitral leaflet. Right: PFE (yellow arrow) arising from the aortic surface of the right aortic valve cusp, immediately adjacent to the right coronary ostium (black ar... More about this image found in PAPILLARY FIBROELASTOMA Left: PFE (yellow arrow) arising from the closing ...