风湿性心脏病合并二尖瓣乳头状弹力纤维瘤 1例

目的探究发生于心脏瓣膜的乳头状弹力纤维瘤的临床及病理特征，为临床治疗提供参考。方法对 1例风湿性心脏病合并二尖瓣腱索乳头状弹力纤维瘤病人，进行手术治疗，对二尖瓣肿物的标本行病理检查进行形态学研究，并复习文献。结果心脏乳头状弹力纤维瘤病人多无特殊症状。心脏超声表现为二尖瓣腱索见一条索状稍强回声。组织学表现为:肿瘤呈乳头状突起，表面被覆单层立方上皮细胞，中心为无血管的轴心区，主要部分是特征性的淡红色的弹力纤维组织。结论风湿性心脏病是一种常见的心脏疾病，而乳头状弹力纤维瘤是一种少见且发病隐匿的心脏肿瘤，病人常无明显症状，可引起栓塞风险。该例肿瘤位于二尖瓣乳头肌腱索处很罕见。术前行超声心动图及手术完整切除肿瘤是提高心脏乳头状弹力纤维瘤病人诊断率及治疗的关键。

Rheumatic heart disease combined with papillary fibroelastoma of the mitral valve chordae: a case report

Objective To explore the clinical and pathological features of papillary fibroelastoma in heart valves, and to provide refer-ence for clinical treatment.Methods One patient with rheumatic heart disease combined with mitral valve chordae papillary fibroelas-toma was treated with surgery, and the specimens of mitral valve mass were pathologically examined for morphological study and litera-ture review was conducted. Results Most patients with papillary fibroelastoma had no special symptoms. Cardiac ultrasound test showed a cord-like slight hyperecho in the mitral valve tendon cord. The histological manifestations showed that the tumor was a papil-lary protrusion covered with a single layer of cubic epithelial cells, with an avascular axial area in the center, and the main part was acharacteristic reddish elastic fibrous tissue.Conclusion Rheumatic heart disease is a common heart disease, while papillary fibroelas-toma is a rare and insidious heart tumor, and patients often have no obvious symptoms, which can cause embolic risk. In this case, thetumor is located at the mitral papillary tendinae cord and is rare. Preoperative echocardiography and complete surgical resection of thetumor are the key to improving the diagnosis and treatment of patients with papillary fibroelastoma in the heart.