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Figure 2 | Journal of Cardiothoracic Surgery

Figure 2

From: Mitral valve surgery for mitral regurgitation caused by Libman-Sacks endocarditis: a report of four cases and a systematic review of the literature

Figure 2

Microscopic histopathological examination of excised mitral valve tissue in patient 2 (A,B), 3 (C,D), and 4 (E,F). (A) Photomicrograph of patient 2. Haematoxylin and Eosin (HE) stain of the atrial surface of the excised mitral valve anterior leaflet. Orginal magnification × 25. (B) Magnified section of A. Original magnification × 400. Fibrinoid changes and neovascularization at the base of the vegetation. The vegetation consists of fibrin-platelet thrombi and shows signs of acute and chronic inflammation with neutrophil and mononuclear cell infiltration. (C) Photomicrograph of patient 3. HE stain of the atrial surface of the excised mitral valve posterior leaflet. Orginal magnification × 50. (D) Magnified section of C. Original magnification × 400. Fibrinoid and hyaline changes at the base of the vegetation. The vegetation itself shows signs of fibroblastic organization of fibrin-platelet thrombus and an inflammatory infiltrate with neutrophils. (E) Photomicrograph of patient 4. HE stain of the atrial surface of the excised mitral valve posterior leaflet. Orginal magnification × 50. (F) Magnified section of E. Original magnification × 200. Fibrinoid and myxoid degenerative changes at the base of the vegetation. The vegetation shows signs of organization of fibrin-platelet thrombus without an evident inflammatory reaction. Sporadically, several neutrophils and mononuclear cells can be found in this section. Black transparant rectangles outline magnified sections shown in the right-hand column. V: vegetation.

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