Publish in this journal
Journal Information
Vol. 71. Issue 2.
Pages 112 (February 2018)
Vol. 71. Issue 2.
Pages 112 (February 2018)
Image in cardiology
Full text access
Multimodality Imaging for Pulmonary Valve Papillary Fibroelastoma
Fibroelastoma en válvula pulmonar. Valoración multimodal por imagen
Albert Teisa,
Corresponding author

Corresponding author:
, Xavier Saenz-Sardàb, Xavier Ruyrac
a Servicio de Cardiología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
b Servicio de Anatomía Patológica, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
c Servicio de Cirugía Cardiaca, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
This item has received
Article information
Full Text
Download PDF
Figures (1)
Additional material (2)
Full Text

A 45-year-old man with Crohn disease was referred for colectomy. Preoperative chest X-ray showed a right pulmonary hilum nodular image that prompted a thoracic computed tomography scan. Incidentally, a round mass was detected in the main pulmonary artery (Figure A, asterisk) and was further confirmed on computed tomography-angiography (Figure B-C; arrows; PA, pulmonary artery; RV, right ventricle). The patient denied prior chest pain, palpitations, dyspnea, or fever. Transthoracic and transesophageal echocardiography identified a round mass attached to the arterial side of the pulmonary valve, with no valve regurgitation. A magnetic resonance scan confirmed the presence of a 12-mm diameter mobile mass attached to the pulmonary valve, which was isointense on T1-weighted images, highly hyperintense on T2, and was not perfused but was enhanced 10minutes after gadolinium administration (Figure D-G, arrows; Video 1 of the supplementary material). Thus, the differential diagnosis between pulmonary valve papillary fibroelastoma and myxoma was established. Cardiac surgery was performed 1 month after colectomy. A well-defined round mucinous mass attached to the tip of the pulmonary valve was easily excised, with valve sparing (Figure H; Video 2 of the supplementary material). It consisted of an elongated and branching papillary proliferation covered by a single layer of cells (Figure I) on hematoxylin-eosin stain, which expressed endothelial cell markers (Figure J) on immunohistochemistry for erythroblast transformation-related gene, thus allowing diagnosis of papillary fibroelastoma.


Papillary fibroelastomas are common, but not in a pulmonary position. The differential diagnosis with myxoma can be difficult, mainly if the masses are round-shaped. Magnetic resonance findings facilitate the diagnosis of a wide range of masses.



Copyright © 2017. Sociedad Española de Cardiología
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

View newsletter history
Article options
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?