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11例原发性心脏瓣膜肿瘤的临床病理研究

[Clinicopathologic studies of 11 cases of primary cardiac valve tumors].

作者信息

Li Li, Wang Hong-yue, Zhao Hong, Ruan Ying-mao, Lü Feng-ying, Wang Qing-zhi, Meng Ying, Liu Lei

机构信息

Department of Pathology, Cardiovascular Institute, Fuwai Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing 100037, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2006 Mar;35(3):142-4.

Abstract

OBJECTIVE

To study the clinicopathologic features of primary cardiac valve tumors.

METHODS

Eleven cases of primary valve tumors collected from Fuwai Hospital during the period from 1983 to 2005 were enrolled into the study. The tumors were stained with hematoxylin and eosin and Weigert-Van Gieson stain. Immunohistochemistry was also carried out in selected examples.

RESULTS

Primary cardiac valve tumors were uncommon and accounted for only 3% (11/426) of all primary cardiac tumors. Most of them (10/11) were benign and malignancy was rarely encountered (1/11). The tumor subtypes included papillary fibroelastoma (4/11), cavernous hemangioma (4/11), glomus tumor (1/11), angiosarcoma (1/11) and hamartoma (1/11). Of the 11 tumors studied, 4 involved the tricuspid valve, 4 involved the mitral valve, 2 involved the pulmonary valve and 1 involved the aortic valve. The diagnosis was established by preoperative echocardiography in 7 patients. The remaining 4 cases were either misdiagnosed or undiagnosed.

CONCLUSIONS

Preoperative diagnosis of primary cardiac valve tumors can be difficult due to lack of detailed information related to this group of lesions. Although benign cardiac valve tumors carry a good prognosis, the clinical outcome may be disastrous as a result of hemodynamic disturbances. Intraoperative frozen section examination is advisable for guiding proper surgical management.

摘要

目的

研究原发性心脏瓣膜肿瘤的临床病理特征。

方法

选取1983年至2005年期间阜外医院收集的11例原发性瓣膜肿瘤病例纳入本研究。肿瘤进行苏木精-伊红染色及魏格特-范吉森染色。部分病例还进行了免疫组织化学检测。

结果

原发性心脏瓣膜肿瘤较为少见,仅占所有原发性心脏肿瘤的3%(11/426)。其中大多数(10/11)为良性,恶性罕见(1/11)。肿瘤亚型包括乳头状纤维弹性瘤(4/11)、海绵状血管瘤(4/11)、血管球瘤(1/11)、血管肉瘤(1/11)和错构瘤(1/11)。在研究的11例肿瘤中,4例累及三尖瓣,4例累及二尖瓣,2例累及肺动脉瓣,1例累及主动脉瓣。7例患者术前经超声心动图确诊。其余4例误诊或未确诊。

结论

由于缺乏与这类病变相关的详细信息,原发性心脏瓣膜肿瘤的术前诊断可能较为困难。尽管良性心脏瓣膜肿瘤预后良好,但因血流动力学紊乱,临床后果可能很严重。建议术中进行冰冻切片检查以指导恰当的手术处理。

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