Abundant dystrophic calcifications mimicking aortic valve abscess in a patient undergoing elective aortic valve replacement.
Abundant dystrophic calcifications mimicking aortic valve abscess in a patient undergoing elective aortic valve replacement.
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DOI：
10.1136/bcr-2017-220368
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发表时间：
2017-07-19
期刊：
影响因子：
0.9
通讯作者：
Stevenson, Heather L
中科院分区：
文献类型：
--
作者：
Booth, Adam L;Li, Christine Q;Stevenson, Heather L
主动脉瓣的营养不良性钙化可能导致症状性主动脉瓣狭窄，并占接受择期瓣膜置换术的患者的很大一部分。钙化在主动脉瓣叶周围表现为混浊的液体是一种罕见的发现。正常情况下，钙化的主动脉瓣的特征是主动脉瓣尖内有大的结节状肿块。我们报告一个在手术中遇到的狭窄主动脉瓣上的营养不良性钙化病例，这提示感染性心内膜炎和脓肿形成。提交主动脉瓣叶和坏死的胸腺淋巴结组织进行组织学和特殊染色。培养物呈阴性，组织学未显示感染证据。组织组织学显示广泛的营养不良性钙化，其被极化以显示丰富的草酸钙晶体。这一独特的病理发现的良性性质排除了任何感染的怀疑，避免了该患者长期静脉注射抗生素。
Dystrophic calcifications of the aortic valve may cause symptomatic aortic stenosis and account for a significant portion of patients who undergo elective valve replacement. Calcifications appearing grossly as a cloudy fluid surrounding the aortic valve leaflets are an uncommon finding. Normally, calcified aortic valves are characterised by large, nodular masses within the aortic cusps. We report a case of dystrophic calcifications on a stenotic aortic valve encountered intraoperatively, which was suggestive of infective endocarditis and abscess formation. Aortic valve leaflets and necrotic-appearing thymic lymph node tissue were submitted for histology and special stains. Cultures were negative and histology did not show evidence of infection. Tissue histology demonstrated extensive dystrophic calcifications, which were polarised to reveal abundant calcium oxalate crystals. The benign nature of this unique pathological finding ruled out any suspicion of infection, avoiding a prolonged course of intravenous antibiotics in this patient.