Steer A, Nakashima T, Kawashima T, Lee K K, Danzig M D, Robertson T L, Dock D S
Jpn Heart J. 1977 Nov;18(6):812-22.
Three types of small cardiac lesions were described and illustrated: (1) focal type of papillary muscle fibrosis, evidently a healed infarct of the papillary muscle present in 13% of autopsies, is a histologically characteristic lesion associated with coronary artery disease and healed myocardial infarction, (2) diffuse type of papillary muscle fibrosis, probably an aging change present in almost half of the autopsies, is associated with sclerosis of the arteries in the papillary muscle, is identifiable histologically, and apparently is not associated with any cardiac abnormality, and (3) focal cardiac myocytolysis, a unique histologic lesion, usually multifocal without predilection for any area of the heart, is associated with ischemic heard disease, death due to cancer complicated by nonbacterial thrombotic endocarditis and microthrombi in small cardiac arteries as well as with other diseases. Differentiation of the 2 types of papillary muscle fibrosis is important in the study of papillary muscle and mitral valve dysfunction. Focal cardiac myocytolysis may contribute to the fatal extension of myocardial infarcts.
（1）局灶性乳头肌纤维化，显然是乳头肌的陈旧性梗死，在13%的尸检中出现，是一种与冠状动脉疾病和陈旧性心肌梗死相关的组织学特征性病变；（2）弥漫性乳头肌纤维化，可能是一种老化改变，几乎在一半的尸检中出现，与乳头肌动脉硬化有关，可通过组织学识别，且显然与任何心脏异常无关；（3）局灶性心肌细胞溶解，一种独特的组织学病变，通常为多灶性，无心脏任何区域的偏好性，与缺血性心脏病、癌症并发非细菌性血栓性心内膜炎和心脏小动脉微血栓导致的死亡以及其他疾病有关。两种类型的乳头肌纤维化的鉴别在乳头肌和二尖瓣功能障碍的研究中很重要。局灶性心肌细胞溶解可能导致心肌梗死的致命扩展。
