Non‐exophytic Lambl excrescences of aortic valves: a morphological study. Issue 2 (4th March 2016)

• Record Type: Journal Article
• Authors: Matsukuma, Susumu; Koga, Ayano; Takeo, Hiroaki; Kato, Kimi; Mori, Kazuma; Sato, Kimiya
• Is Part Of: Histopathology. Volume 69:Issue 2(2016)
• Page Start: 307
• Page End: 314
• Publication Date: 2016-03-04
• Subjects: aortic valve -- Lambl excrescence -- papillary fibroelastoma; Histology, Pathological -- Periodicals; 611.018
• DOI: 10.1111/his.12938
• Languages: English
• ISSNs: 0309-0167

Abstract

Abstract : Aims: To elucidate the histopathological findings of classical Lambl excrescences (LEs) and non‐exophytic LEs (non‐ex LEs) without excrescent papillary features. Methods and results: We examined 126 aortic valves (AVs) and revealed LEs (non‐ex and/or classical), non‐ex LEs and classical LEs in 106, 78 and 88 AVs, respectively. The detection of non‐ex LEs was challenging, but elastica van Gieson stain highlighted their presence. Non‐ex and classical LEs chiefly involved the ventricular regions, favoured posterior cusps and coexisted in the same areas of 31 AVs. A possible transformation of classical LEs into non‐ex LEs was suggested histologically in 39 AVs. Non‐ex LEs were associated with age of >70 years ( P < 0.001) and marked deformity ( P = 0.007). Classical LEs were associated inversely with marked deformity ( P < 0.001), but not with age of >70 years. Compared with age‐ and sex‐matched control AVs, non‐ex LEs and marked deformity in dysfunctional AVs were more common ( P = 0.037 and P < 0.001, respectively), but classical LEs were less common ( P = 0.021). Conclusions: Non‐ex LEs have subtle features but are a common form of LEs, and seem to develop from classical LEs. AV dysfunction‐related marked deformity can promote non‐ex LEs.