(5) Papillary fibroelastomas have been referred to by a variety of names, including cardiac papilloma, myxofibroma, papillary fibroma, and giant Lambl excrescences
. Most reports agree that they are best termed papillary fibroelastoma on morphologic and histologic grounds, and are not simply giant Lamb] excrescences.
The papilliferous surface is considered to result from exposure to the hemodynamic stress of flowing blood.[1,4] Lambl excrescences origin was suggested, but most authors believe that PFE is a separate entity. Other theories suggest that PFEs represent neoplasms, hamartomas, and inflammatory nodules.[4,7]
The differential diagnosis of PFE includes other papilliferous lesions of the heart, such as myxomas, Lambl excrescences, bacterial vegetations, and organizing marantic (thrombotic) endocarditis.[6,8] Myxomas most frequently originate from the wall of the left or right atrium and are rarely located on the valve surface.