心脏乳头肌上皮囊肿：病例报告及文献复习
Epithelial cyst of the cardiac papillary muscle: case report and review of the literature.
作者信息
Soilleux E J, Davies D R
机构信息
Department of Histopathology, John Radcliffe Hospital, Oxford, UK.
出版信息
J Clin Pathol. 2006 Nov;59(11):1203-5. doi: 10.1136/jcp.2005.030312.
BACKGROUND
Reports of endodermal heterotopia (previously known as inclusion cysts) in cardiac atria are rare and there is only a single previous case report of endodermal heterotopia in a cardiac papillary muscle.
AIM AND METHODS
A cyst in a cardiac papillary muscle was identified during the autopsy of an 87-year-old man who had died from an unrelated myocardial infarction. The cyst was examined histologically and mucin staining and immunostaining were carried out.
RESULTS
We report a unilocular cyst in a cardiac papillary muscle, which is lined by low cuboidal, pseudostratified and occasionally ciliated respiratory-type epithelium, surrounded by a layer of smooth muscle. The immunohistochemical features (MNF116+, cytokeratin (CK)7+, CK8+, CK18+, CK19+, epithelial membrane antigen positive, scattered cells positive for neuroendocrine markers) suggest that this is an endodermal heterotopia. Immunostaining of positive thyroid transcription factor-1 provides evidence for bronchogenic differentiation.
DISCUSSION
The differential diagnoses of cystic structures in cardiac papillary muscle and the origin and importance of endodermal heterotopias are discussed.
背景
心腔内出现内胚层异位（以前称为包涵囊肿）的报道较为罕见，此前仅有一例关于心脏乳头肌内胚层异位的病例报告。
目的和方法
在一名因无关的心肌梗死死亡的87岁男性尸检过程中，发现了心脏乳头肌内的一个囊肿。对该囊肿进行了组织学检查，并进行了黏液染色和免疫染色。
结果
我们报告了一例心脏乳头肌内的单房囊肿，其内壁衬以低立方、假复层且偶尔有纤毛的呼吸道型上皮，周围有一层平滑肌。免疫组化特征（MNF116+、细胞角蛋白（CK）7+、CK8+、CK18+、CK19+、上皮膜抗原阳性、散在细胞神经内分泌标志物阳性）提示这是一个内胚层异位。甲状腺转录因子-1阳性的免疫染色为支气管源性分化提供了证据。
讨论
讨论了心脏乳头肌囊性结构的鉴别诊断以及内胚层异位的起源和重要性。
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