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Bi-atrial cardiac myxoma with glandular differentiation: a case report with detailed radiologic-pathologic correlation.

ABSTRACT: Introduction:Myxoma is the most common cardiac benign tumour. While a typical myxoma is generally a straightforward diagnosis, some myxomas have unusual features that can make the diagnosis challenging. Glandular myxomas and metastatic adenocarcinomas, the most common type of metastatic carcinoma to the heart, can have very similar features. Case presentation:We report a 60-year old man who presented with progressive shortness of breath on exertion. Echocardiography demonstrated a large heterogeneous, cystic left and right atrial mass. He was referred for surgery where a smooth and multilobulated left atrial mass was excised. Histopathological analysis with special stains revealed an unusual form of cardiac myxoma with extensive glandular differentiation. Discussion:Cardiac myxomas can present with diverse clinical, radiological, and pathological features. Echocardiography is a modality of choice for diagnosis but can also miss small or multiple masses. Cardiac myxoma with glandular features is a rare type of myxoma. In our case, there was extensive glandular differentiation and the echocardiographic appearance provided clues for the unusual features of the tumour, suggesting a potential role for echocardiography in the detection and recognition of this morphologic histologic variation.

SUBMITTER: Flint N

PROVIDER: S-EPMC6177082 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Bi-atrial cardiac myxoma with glandular differentiation: a case report with detailed radiologic-pathologic correlation.

Flint Nir N Siegel Robert J RJ Bannykh Serguei S Luthringer Daniel J DJ

European heart journal. Case reports 20180416 2

<h4>Introduction</h4>Myxoma is the most common cardiac benign tumour. While a typical myxoma is generally a straightforward diagnosis, some myxomas have unusual features that can make the diagnosis challenging. Glandular myxomas and metastatic adenocarcinomas, the most common type of metastatic carcinoma to the heart, can have very similar features.<h4>Case presentation</h4>We report a 60-year old man who presented with progressive shortness of breath on exertion. Echocardiography demonstrated a ...[more]

PMID: 31020125

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Project description:To determine whether computed tomographic (CT) attenuation values correlate with the histologic measurements of a lung cancer manifesting as a nonsolid nodule and to quantify the extent to which the tumor replaces the airspace within the nodule.Informed consent was obtained to analyze images from CT and pathologic examination under an institutional review board-approved protocol. Fifteen patients who had undergone resection of nonsolid lung cancer were evaluated. On the basis of the CT attenuation values of nonsolid nodules, nonneoplastic lung, soft tissue, and air, the overall proportion of soft tissue in the nodule and nonneoplastic lung and the difference between these two measures were calculated. The analogous measures were obtained from a representative digitized histologic slide. The area of each nodule and the proportion of air within it were measured, and the proportion of soft tissue in the nodule and nonneoplastic lung and the difference between the two were calculated. The difference between the two proportions at CT and histologic examination are the proportions attributable to the cancer on the basis of CT and histologic examinations, respectively. Linear regression was performed to assess the relationship between these measures.The average proportions of soft tissue in the nodule at CT and histologic examination were 48% and 69%, respectively, and they showed significant correlation with each other (P = .02); in addition, each showed significant correlation with the attenuation of the nodule (P < .0001 and P = .02, respectively). The difference between the proportions of soft tissue in nodule and nonneoplastic lung at CT and histologic examination were 37% and 30%, respectively, and both were independent of the tumor diameter (P = .26 and P = .41).The proportion of soft tissue within a nonsolid nodule is correlated with attenuation at CT. This allows for measurement of change within the nodule. An increase of 100 HU in nodule attenuation represents an approximately 10% increase in tumor volume.

Dataset Information

Bi-atrial cardiac myxoma with glandular differentiation: a case report with detailed radiologic-pathologic correlation.

Publications

Bi-atrial cardiac myxoma with glandular differentiation: a case report with detailed radiologic-pathologic correlation.

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