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The carcinoid endocardial plaque; an ultrastructural study

V J Ferrans, W C Roberts

    Human Pathology
    |July 1, 1976
    PubMed
    Summary

    Carcinoid syndrome causes plaque-like endocardial thickenings composed of smooth muscle cells. These plaques result from healing endocardial injury, possibly initiated by bradykinin from carcinoid tumor metastases.

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    Area of Science:

    • Cardiovascular Pathology
    • Oncology
    • Ultrastructural Biology

    Background:

    • Carcinoid syndrome is associated with cardiac manifestations, including endocardial plaques.
    • The precise ultrastructure and origin of these endocardial lesions remain incompletely understood.

    Purpose of the Study:

    • To investigate the ultrastructural composition and cellular origin of endocardial thickenings in patients with carcinoid syndrome.
    • To elucidate the potential pathogenetic mechanisms underlying the development of these cardiac lesions.

    Main Methods:

    • Ultrastructural analysis (electron microscopy) of endocardial plaques from three patients with carcinoid syndrome.
    • Histological examination of plaque morphology and composition.

    Main Results:

    • Endocardial plaques consist of smooth muscle cells within a stroma rich in acid mucopolysaccharides, collagen, and microfibrils, lacking elastic fibers.
    • Smooth muscle cells exhibit features like myofilaments and abundant rough endoplasmic reticulum, with significantly thickened, layered basement membranes.
    • Plaques show histological and ultrastructural consistency across different cardiac locations.

    Conclusions:

    • Endocardial plaques in carcinoid syndrome are composed of smooth muscle cells originating from subendocardial mesenchymal cells.
    • These plaques likely represent a healing response to superficial endocardial injury, potentially triggered by bradykinin released from carcinoid metastases.

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