Abstract

We present a case of cardiac fibroma encountered as an incidental finding at autopsy of an 83-year-old man without a previous clinical symptomatology. Autopsy examination of the thoracic cavity showed an enlarged heart, and a cut along the obtuse margin of the heart revealed a rather well-circumscribed, intramural mass occupying the left ventricle that measured 6×3.5×2.5 cm (Fig. 1a). The external surface was smooth, and the cut surface was hard and gray–white. No hemorrhage or necrosis was identified. The tumor tissue was obtained for both light and electron microscopy. Histologically, the tumor was not encapsulated and was composed mainly of interlacing bundles of dense collagen fibers. A few scattered spindle cells with morphological features of fibroblasts admixed with collagen fibers were recognized (Fig. 1b). The fibroblasts displayed non-atypical features, and mitoses were absent. Immunohistochemically, the cells showed a strong positivity for vimentin, whereas all other markers were negative. At the margin of the tumor, the collagen tissue intermingled with the adjacent myocardial fibers. Elastic fibers that stained red with Verrhoeff-van Gieson stain were also found (Fig. 2a). Upon electron microscopic examination, the tumor was found to be composed of abundant bundles of collagen and elastic fibers. Adjacent to collagen fibers, rare spindle-shaped cells with elongated nuclei were identified (Fig. 2b). Some of the cells had an attenuated cytoplasm but in others, the cytoplasm was more prevalent, and a rich network of rough endoplasmic reticulum was recognized. A basal lamina was not apparent. The elongated nucleus, the abundant rough endoplasmic reticulum, the absence of basal lamina, and the associated extracellular collagen were consistent with fibroblastic differentiation. Fibroblasts and collagen were seen to extend between groups of cardiac muscle fibers at the periphery of the tumor. Cardiac fibromas are rare benign tumors in adults that account for approxi-

DOI: 10.1007/s004280100442

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Cite this paper

@article{Vougiouklakis1969CardiacF, title={Cardiac fibroma}, author={Th. Vougiouklakis and Anna C Goussia and Elli E. Ioachim and Dimitrios Peschos and Niki John Agnantis}, journal={Virchows Archiv}, year={1969}, volume={438}, pages={635-636} }