Prichard's structures of the fossa ovalis are age-related phenomena composed of nonreplicating endothelial cells: the cardiac equivalent of cutaneous senile angioma
Prichard's structures of the fossa ovalis are age-related phenomena composed of nonreplicating endothelial cells: the cardiac equivalent of cutaneous senile angioma
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DOI：
10.1111/j.1600-0643.2007.00756.x
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发表时间：
2007-11-01
期刊：
影响因子：
2.8
通讯作者：
Francisca Garijo, M.
中科院分区：
文献类型：
--
作者：
Fernando Val-Bernal, J.;Martino, Maria;Francisca Garijo, M.
Prichard的结构或微小的心内膜畸形，伴有毛细血管大小的腔隙，内衬着位于卵圆窝的丰满的内皮细胞，是一种原因不明的年龄相关性改变。在本报告中，我们对这些结构的组织发生、增殖潜能和在老年人中的发生率进行了研究。我们在尸检中获得的一系列70岁患者的连续心脏标本中，对卵圆窝进行了前瞻性的组织学研究。应用免疫组织化学方法对6例有上述结构的病例进行波形蛋白、CD31、CD34、血栓调节蛋白、c-kit(CD117)、Ki67(MIB1)和血管内皮生长因子受体2的免疫组织化学染色。在50例(45%)心脏中观察到了普里查德结构，且男性更常见。我们证实这些结构是与年龄相关的现象。内皮下结构比腔内结构更常见。大多数人的Prichard‘s结构位于右侧，但卵圆窝左侧的结构较多。免疫组织化学研究表明，Prichard的结构由成熟的、完全分化的、有丝分裂后类型的内皮细胞组成。我们认为，普里查德的结构是由卵圆窝心内膜内皮细胞内折形成的，这是对血流变化、涡流或湍流的刺激反应。可以在普里查德结构和老年性血管瘤之间建立类似的关系，因为这两种结构都随着年龄的增长而增加；它们不是真正的肿瘤；它们是由终末分化的内皮细胞组成的过度生长。我们认为Prichard结构是皮肤老年性血管瘤的心脏等价物。
Prichard's structures or minute endocardial deformities with lacunas of capillary size lined by plump endothelial cells located in the fossa ovalis are an age-related alteration of unknown origin. In this report the histogenesis, the proliferative potential and the incidence in the aged of these structures are investigated. We have undertaken a prospective histological study of the fossa ovalis in a series of I I I consecutive hearts of patients aged >= 70 years obtained at autopsy. Included in this study was inummohistochemical staining for vimentin, CD31, CD34, thrombomodulin, c-kit (CD117), Ki67 (MIB1) and vascular endothelial growth factor receptor 2 in six cases showing these structures. Prichard's structures were observed in 50 hearts (45%), and were more frequent in males. We confirmed that these structures are age-related phenomena. Subendothelial structures were more common than intracavitary structures. Most individuals had Prichard's structures located on the right side; however, the structures were more numerous on the left side of the fossa ovalis. The inummohistochemical study revealed that Prichard's structures consisted of adult, fully differentiated, postmitotic-type endothelial cells. We suggest that Prichard's structures are formed by infolding of the endothelial lining of the endocardium of the fossa ovalis as an irritational response to altered blood flow, eddies or turbulence. A parallel can be established between Prichard's structures and senile angiomas as both structures increase with age; they are not genuine neoplasms; and they are overgrowths made up of endothelial cells with terminal differentiation. We propose that Prichard's structures are the cardiac equivalent of cutaneous senile angioma.