Die Lambl'sche Exkreszenz als tumoröse Herzklappenveränderung
| Autor: | C. Punzengruber, Robert Berent, M. Rossoll, P. Hartl |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Aortic valve
medicine.medical_specialty medicine.diagnostic_test business.industry Physical examination General Medicine medicine.disease Malignancy Benign tumor Surgery Otitis medicine.anatomical_structure cardiovascular system medicine Left axis deviation Sinus rhythm medicine.symptom Transthoracic echocardiogram business |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 123:423-426 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2007-1023981 |
| Popis: | HISTORY AND CLINICAL FINDINGS A 44 year old woman consulted a general physician because of weakness and fatigue. 5 months ago otitis media and a urinary tract infection had been treated successfully with antibiotics. The physical examination was unremarkable except for healed scars after an orthopedic operation about 35 years ago and a resection of a benign tumor of the left breast about 14 years ago. INVESTIGATIONS Except for a slightly elevated antistreptolysin titer the laboratory tests were normal. The ECG showed sinus rhythm, left axis deviation and normal ST-segments. In the transthoracic echocardiogram an echogenic mass adherent on the ventricular side of the noncoronary cusp of the aortic valve in size of 2 x 1.5 cm could be demonstrated. The mass moved with the normally functioning valve and prolapsed into the aorta ascendens. The Doppler-echocardiogram was normal. TREATMENT AND COURSE Because of the size of this echogenic mass with unknown origin and the risk of an embolic event its removal was indicated. This was done without destroying the aortic valve. Postoperative echocardiography demonstrated normal valve function. The histologic examination showed an endothelialized mass, rich in fibers and with only a few fibroblasts and histiocytes, without smooth muscle cells, according to a Lambl's excrescence. CONCLUSION Cardiac valve tumors are rare. The differentiation between surface excrescences on the cardiac valve and neoplasia is only possible by histologic examination. Because of its possible malignancy and the potential risk of emboli surgical treatment is indicated. |
| Databáze: | OpenAIRE |
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