左房内発生乳頭状線維弾性腫の切除手術の1例

Surgical Resection Papillary Fibroelastoma Arising from Left Atrium：Report of a Case

はじめに　乳頭状線維弾性種は原発性心臓腫瘍の中でも比較的まれな疾患であり，その多くは弁組織より発生することが知られている．左房内に発生する例は報告がきわめて少ない．われわれは，脳梗塞で発症し，腫瘍の発生部位が左心耳付近であったために血栓との鑑別に難渋し，診断・手術までに時間を要した症例を経験したので報告する．

A 75-year-old man was admitted for cerebral infarction. Magnetic resonance imaging revealed parietal lobe cerebral infarction. Transesophageal echo and contrast-enhanced computed tomography indicated mobile and speckled mass arising from left atrium. He was diagnosed with cardiogenic cerebral embolism. Under cardiopulmonary bypass, resection of the mass including endocardium tissue was performed. The resected specimen showed multiple small fronds resembling a sea anemone. Microscopic examination showed multiple branching fronds of paucicellular and avascular fibroelastic tissue lined by a single layer of endocardium. Pathological diagnosis was papillary fibroelastoma. Three years passed without recurrence.