Heart
Cardiac tumors - benign
Papillary fibroelastoma

Author: Nat Pernick, M.D. (see Authors page)

Revised: 20 March 2018, last major update November 2013

Copyright: (c) 2007-2018, PathologyOutlines.com, Inc.

PubMed Search: Papillary fibroelastoma [title] heart pathology review[ptyp]

Cite this page: Pernick, N. Papillary fibroelastoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/hearttumorfibroelastoma.html. Accessed July 18th, 2018.
Definition / general
  • Also called giant Lambl excrescence
  • 8 - 10% of all heart tumors; third most common after myxoma and lipoma
  • Mean age 60 years
  • Benign
  • Usually an incidental finding at autopsy, although may embolize (higher risk if large, mobile, left sided, Circulation 2001;103:2687), or prolapse into coronary artery
  • More common on valve surface or endocardium
  • Associated with prior cardiac surgery or thoracic radiation (Hum Pathol 2002;33:1165)
Case reports
Treatment
  • Either no intervention, excision or warfarin
Gross description
  • Distinctive cluster of yellow-white hair-like projections up to 1 cm in diameter covering large portions of valvular surface (usually aortic and mitral)
Gross images

Images hosted on PathOut server:
Missing Image

Mitral valve

Missing Image

Tumor in noncoronary sinus



Images hosted on other servers:
Missing Image Missing Image

Multiple small fronds resembling a sea anemone

Missing Image

Causing sudden
death due to
occlusion of right
coronary ostium
Microscopic (histologic) description
  • Narrow, elongated and branching papillary fronds composed of central avascular collagen and variable elastic tissue, surrounded by acid mucopolysaccharide and lined by hyperplastic endothelial cells
Microscopic (histologic) images

Images hosted on PathOut server:
Missing Image

Arising from aortic valve cusp

Missing Image

Movat pentachrome stain

Missing Image

Avascular fronds lined by endothelial cells

Missing Image

Papillary configuration may
be obscured by scarring,
but trapped cores of elastic
tissue are usually present


Images hosted on other servers:
Missing Image

Colloidal iron stain

Missing Image

Avascular fronds lined by endothelial cells

Differential diagnosis