PMC5385231_01
Axial images of diffusion-weighted MRI of the brain with contrast showing hyperintensity in the temporal and occipital lobes.
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MRI of the brain with contrast showed abnormal signal in the right parietal lobe and other areas of small bright signals in the temporal lobe, occipital white matter, and right cerebellum consistent with multiple subacute infarcts (Figure 1).
Transesophageal echocardiogram (TEE) image showing a pedunculated mass on the atrial aspect of the posterior leaflet of the mitral valve before surgical resection of the CPFE.
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Transesophageal echocardiogram showed an 8 x 5 mm pedunculated mass on the atrial aspect of the posterior leaflet of the mitral valve (Figure 2), suggesting either a cardiac tumor or a vegetation of infectious or noninfectious etiology.
Surgical resection of the cardiac mass.
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The patient was evaluated by cardiothoracic surgery and the lesion was resected three weeks later (Figure 3).
Transesophageal echocardiogram (TEE) image showing a preserved mitral valve after surgery resection of the CPFE.
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Repeat TEE demonstrated the complete removal of the pedunculated mass (Figure 4).
(a) H&E 40x reveals multiple papillary structures lined by endothelial cells; (b) H&E 100x reveals the papillary structures are avascular and contain fibromyxoid stroma; (c) H&E 400x reveals the papillary structures are lined by bland endothelial cells.
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Pathology showed papillary structures lined by endothelium consisting of fibromyxoid stroma with dense areas of hyalinized stroma, confirming the diagnosis of a papillary fibroelastoma of the mitral valve (Figure 5).