case_images: PMC6349987_01
case_images: The patient has multiple cutaneous neurofibromas on the trunk.
case_images: 10.1177_2050313X18818724-fig1.jpg
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case_images: On examination, multiple cafe au lait skin macules and subcutaneous neurofibromas were seen (Figure 1).
case_images: Image of 3D computed tomography demonstrating the LITA and SVG.
case_images: 10.1177_2050313X18818724-fig2.jpg
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case_images: On follow-up coronary computed tomography performed 1 month after CABG, the grafts were patent, and the native coronary artery or LITA graft and SVG showed no suspicious changes (Figure 2).
case_images: Pathological examination of the internal thoracic arterial wall showing (a) hematoxylin and eosin stain; (b) Elastica Masson stain; (c) extended image, showing thinning of media and proliferation of intima (black circle); and (d) extended image, showing fragmentation of elastic tissue (red circle).
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case_images: The residual LITA vessel pathology in this patient included intimal proliferation, medial thinning, and fragmentation of elastic tissue (Figure 3).
case_images: Immunohistochemical analysis for antibodies against S-100 protein (immunostaining for neurofilaments). Normal fibroma diffused in connective tissue becomes positive (black circle), but there are no positive cells in the internal thoracic arterial wall.
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case_images: However, immunohistochemical analysis of the proliferating cells was negative for antibodies against S-100 protein (immunostaining for neurofilaments; Figure 4).