Myxomatous degeneration
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| Myxomatous degeneration | |
|---|---|
| Diagnosis in short | |
 Myxomatous valve. Movat stain. (WC) | |
|
| |
| LM | thinning of fibrosa layer, thickening of spongiosa layer with mucoid (myxomatous) material, +/-secondary changes due to valvular dysfunction (e.g. thrombi, fibrosis) |
| Stains | Movat stain - to demonstrate mucoid material |
| 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 notes | Mitral valve grossing |
| Site | heart valve, typical mitral valve |
|
| |
| Syndromes | Marfan's syndrome, Turner syndrome |
|
| |
| Prevalence | uncommon |
| Treatment | 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,[1] disputed by Toronto data.[2]
- Associated with Marfan's syndrome and Turner syndrome (Monosomy X).[3]
Gross
Features:[4]
- 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.
Interpretation of Movat stain:[6]
- Black = nuclei and elastic fibers.
- Yellow = collagen and reticular fibers.
- Blue = mucin, ground substance.
- Red (intense) = fibrin.
- Red = muscle.
Image
Myxomatous valve. Movat stain. (WC/Nephron)
See also
References
- ↑ URL: http://emedicine.medscape.com/article/759004-overview. Accessed on: 8 June 2010.
- ↑ Leong SW, Soor GS, Butany J, Henry J, Thangaroopan M, Leask RL (October 2006). "Morphological findings in 192 surgically excised native mitral valves". Can J Cardiol 22 (12): 1055-61. PMID 17036100.
- ↑ Wigle ED, Rakowski H, Ranganathan N, Silver MC (1976). "Mitral valve prolapse". Annu. Rev. Med. 27: 165–80. doi:10.1146/annurev.me.27.020176.001121. PMID 779595.
- ↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 591. ISBN 0-7216-0187-1.
- ↑ URL: http://www.mayomedicallaboratories.com/test-catalog/Overview/9832. Accessed on: 8 June 2010.
- ↑ 6.0 6.1 Modified Movat's Pentachrome Stain. University Penn Medicine. URL: http://www.med.upenn.edu/mcrc/histology_core/movat.shtml. Accessed on: January 29, 2009.