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Difference between revisions of "Myxomatous degeneration"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Myxomatous_aortic_valve.jpg | |||
| Width = | |||
| Caption = Myxomatous valve. [[Movat stain]]. (WC) | |||
| Synonyms = | |||
| Micro = thinning of fibrosa layer, thickening of ''spongiosa layer'' with mucoid (myxomatous) material, +/-secondary changes due to valvular dysfunction (e.g. thrombi, fibrosis) | |||
| Subtypes = | |||
| LMDDx = | |||
| Stains = [[Movat stain]] - to demonstrate mucoid material | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = valve thickened, rubbery consistency, reactive/secondary changes common (fibrosis due to prolapse/abnormal contact of valve with other structures, clots/organized thrombus due to stasis) | |||
| Grossing = [[Mitral valve grossing]] | |||
| Site = [[heart valve]], typical mitral valve | |||
| Assdx = | |||
| Syndromes = [[Marfan's syndrome]], [[Turner syndrome]] | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
| Tx = surgical replacement | |||
}} | |||
'''Myxomatous degeneration''' of [[heart valves]] is rare benign condition that is typically seen in the mitral valve, and may be associated with various genetic conditions. | |||
==General== | |||
*Usually affects the mitral valve. | |||
*Female > male,<ref>URL: [http://emedicine.medscape.com/article/759004-overview http://emedicine.medscape.com/article/759004-overview]. Accessed on: 8 June 2010.</ref> disputed by Toronto data.<ref name=leong>{{cite journal |author=Leong SW, Soor GS, Butany J, Henry J, Thangaroopan M, Leask RL |title=Morphological findings in 192 surgically excised native mitral valves |journal=Can J Cardiol |volume=22 |issue=12 |pages=1055-61 |year=2006 |month=October |pmid=17036100 |doi= |url=}}</ref> | |||
*Associated with [[Marfan's syndrome]] and [[Turner syndrome]] (Monosomy X).<ref name=pmid779595>{{cite journal |author=Wigle ED, Rakowski H, Ranganathan N, Silver MC |title=Mitral valve prolapse |journal=Annu. Rev. Med. |volume=27 |issue= |pages=165–80 |year=1976 |pmid=779595 |doi=10.1146/annurev.me.27.020176.001121 |url=}}</ref> | |||
==Gross== | |||
Features:<ref name=Ref_PBoD591>{{Ref PBoD|591}}</ref> | |||
*No commissural fusion. | |||
**Commissural fusion typical of rheumatic heart disease. | |||
*Thickened. | |||
*Rubbery consistency. | |||
*Reactive/secondary changes. | |||
**Fibrosis due to prolapse/abnormal contact of valve with other structures. | |||
**Clots/organized thrombus - due to stasis. | |||
==Microscopic== | |||
*Thinning of ''fibrosa layer''. | |||
*Thickening of ''spongiosa layer'' with mucoid (myxomatous) material. (key feature). | |||
*+/-Secondary changes (due to valvular dysfunction): thrombi, fibrosis. | |||
==Staining== | |||
*Movat stain. | |||
**Acid fuchsin, alcian blue, crocein scarlet, elastic hematoxylin, pathology consultation, and saffron.<ref>URL: [http://www.mayomedicallaboratories.com/test-catalog/Overview/9832 http://www.mayomedicallaboratories.com/test-catalog/Overview/9832]. Accessed on: 8 June 2010.</ref><ref name=penn_med>Modified Movat's Pentachrome Stain. University Penn Medicine. URL: [http://www.med.upenn.edu/mcrc/histology_core/movat.shtml http://www.med.upenn.edu/mcrc/histology_core/movat.shtml]. Accessed on: January 29, 2009.</ref> | |||
Interpretation of Movat stain:<ref name=penn_med/> | |||
*Black = nuclei and elastic fibers. | |||
*Yellow = collagen and reticular fibers. | |||
*Blue = mucin, ground substance. | |||
*Red (intense) = fibrin. | |||
*Red = muscle. | |||
===Image=== | |||
<gallery> | |||
Image:Myxomatous_aortic_valve.jpg | Myxomatous valve. [[Movat stain]]. (WC/Nephron) | |||
</gallery> | |||
==See also== | |||
*[[Heart valves]]. | |||
==References== | |||
{{reflist|2}} | |||
[[Category:Diagnosis]] | |||
[[Category:Heart valves]] | |||