小疣状赘生物呈串珠状沿着心脏瓣膜的闭锁缘排列。本例病人患有系统性红斑狼疮,这类赘生物可见于任何瓣膜乃至心内膜上,并且在形态上与Libman-Sacks心内膜炎 的赘生物一致。系统性红斑狼疮病人仅有4%出现,并且赘生物小不易脱落,因此对机体的影响较小。注意腱索变厚、缩短、粘连,这是风湿性心脏病的表现。
Here are flat, pale tan, spreading vegetations over the mitral valve surface and even on the chordae tendineae. This patient has systemic lupus erythematosus. Thus, these vegetations that can be on any valve or even on endocardial surfaces are consistent with Libman-Sacks endocarditis. These vegetations appear in about 4% of SLE patients and rarely cause problems because they are not large and rarely embolize. Note also the thickened, shortened, and fused chordae tendineae that represent remote rheumatic heart disease.