PMC6349987_01
The patient has multiple cutaneous neurofibromas on the trunk.
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On examination, multiple cafe au lait skin macules and subcutaneous neurofibromas were seen (Figure 1).
Image of 3D computed tomography demonstrating the LITA and SVG.
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On follow-up coronary computed tomography performed 1 month after CABG, the grafts were patent, and the native coronary artery or LITA graft and SVG showed no suspicious changes (Figure 2).
Pathological examination of the internal thoracic arterial wall showing (a) hematoxylin and eosin stain; (b) Elastica Masson stain; (c) extended image, showing thinning of media and proliferation of intima (black circle); and (d) extended image, showing fragmentation of elastic tissue (red circle).
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The residual LITA vessel pathology in this patient included intimal proliferation, medial thinning, and fragmentation of elastic tissue (Figure 3).
Immunohistochemical analysis for antibodies against S-100 protein (immunostaining for neurofilaments). Normal fibroma diffused in connective tissue becomes positive (black circle), but there are no positive cells in the internal thoracic arterial wall.
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However, immunohistochemical analysis of the proliferating cells was negative for antibodies against S-100 protein (immunostaining for neurofilaments; Figure 4).