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Non‐exophytic Lambl excrescences of aortic valves: a morphological study
Author(s) -
Matsukuma Susumu,
Koga Ayano,
Takeo Hiroaki,
Kato Kimi,
Mori Kazuma,
Sato Kimiya
Publication year - 2016
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12938
Subject(s) - van gieson's stain , deformity , anatomy , medicine , aortic valve , pathology , surgery , staining , h&e stain
Aims To elucidate the histopathological findings of classical Lambl excrescences ( LE s) and non‐exophytic LE s (non‐ex LE s) without excrescent papillary features. Methods and results We examined 126 aortic valves ( AV s) and revealed LE s (non‐ex and/or classical), non‐ex LE s and classical LE s in 106, 78 and 88 AV s, respectively. The detection of non‐ex LE s was challenging, but elastica van Gieson stain highlighted their presence. Non‐ex and classical LE s chiefly involved the ventricular regions, favoured posterior cusps and coexisted in the same areas of 31 AV s. A possible transformation of classical LE s into non‐ex LE s was suggested histologically in 39 AV s. Non‐ex LE s were associated with age of >70 years ( P < 0.001) and marked deformity ( P = 0.007). Classical LE s were associated inversely with marked deformity ( P < 0.001), but not with age of >70 years. Compared with age‐ and sex‐matched control AV s, non‐ex LE s and marked deformity in dysfunctional AV s were more common ( P = 0.037 and P < 0.001, respectively), but classical LE s were less common ( P = 0.021). Conclusions Non‐ex LE s have subtle features but are a common form of LE s, and seem to develop from classical LE s. AV dysfunction‐related marked deformity can promote non‐ex LE s.