Fibroelastoma Recurrence in Left Ventricle: Rarity of Primary Cardiac Tumor.
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ABSTRACT:
SUBMITTER: Kammerer I
PROVIDER: S-EPMC5530623 | biostudies-other | 2015 Dec
REPOSITORIES: biostudies-other
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Project description:IntroductionPrimary cardiac lymphoma accounts for <2% of all primary cardiac tumours. It is uncommon in immunocompetent patients, often fatal and diagnosed at autopsy. Tumour usually involves the right heart chambers and pericardium. With advances in imaging, early diagnosis is possible and treatment including chemotherapy and surgery affords good prognosis.Case presentationWe present a 50-year-old woman with abdominal pain and fevers for 5 days. Computed tomography of the abdomen showed splenic and renal infarcts but no mass or vegetation was noted on echocardiography. Thoracic computed tomography divulged a large left ventricular filling defect. Cardiac magnetic resonance imaging delineated a 3.5?×?4.5?cm anterobasal mass with frond-like projections and endocardial invasion without extracardiac involvement suggestive of a low-vascularity tumour. Echo-guided endomyocardial biopsy and minithoracotomy with needle biopsy were inconclusive. A sarcoid-protocol cardiac positron emission tomography-fluorodeoxyglucose scan showed focally elevated uptake in the basal anteroseptum without extracardiac uptake, supporting a malignant entity. This prompted open heart mass resection. Pathology revealed diffuse large B-cell lymphoma.DiscussionOur case is a unique report of cardiac lymphoma isolated to the left ventricle. Location of the tumour and lack of specific imaging characteristics made it a diagnostic challenge. It underscores the importance of including lymphoma in the differential for intracardiac masses as it is responsive to chemotherapy. Additionally, it emphasizes the complementary role of imaging modalities and multidisciplinary team approach in diagnosis. Early diagnosis and therapy is the key to establishing successful outcomes.
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Project description:Background:Surgery is the fundamental method for the treatment of primary cardiac tumours. However, due to the inaccessibility of anatomy and the proximity of important structures, it is very difficult to completely resect tumours of the left atrium or left ventricle without damaging the normal tissues. Cardiac autotransplantation for the resection of cardiac tumours is carried out by taking out the heart from the body, resecting cardiac tumours, and then transplanting the heart back into the body. Case summary:This article presents a successful case of cardiac autotransplantation for the complete resection of primary cardiac tumour in a 2-month-old infant and shares the noteworthy experience. Discussion:Tumours located in the left atrium and left ventricle are difficult to be exposed because of their deep posterior location and proximity to important anatomical structures such as mitral valve and chordae tendineae. How to resect the tumours completely without damaging the normal tissues is a great challenge. This case proves that cardiac autotransplantation is a good solution for tumours that are difficult to be resected completely by orthotopic cardiac transplantation.
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Project description:In this article, the authors present a motion-compensated spatiotemporal processing algorithm to reduce noise in cardiac gated SPECT. Cardiac gated SPECT data are particularly noisy because the acquired photon data are divided among a number of time frames (gates). Classical spatial reconstruction and processing techniques offer noise reduction but they are usually applied on each frame separately and fail to utilize temporal correlation between frames.In this work, the authors present a motion-compensated spatiotemporal postreconstruction filter offering noise reduction while minimizing motion-blur artifacts. The proposed method can be used regardless of the type of image-reconstruction method (analytical or iterative). The between-frame volumetric myocardium motion is estimated using a deformable mesh model based on the model of the myocardial surfaces. The estimated motion is then used to perform spatiotemporal filtering along the motion trajectories. Both the motion-estimation and spatiotemporal filtering methods seek to maintain the wall brightening seen during cardiac contraction. Wall brightening is caused by the partial volume effect, which is usually viewed as an artifact; however, wall brightening is a useful signature in clinical practice because it allows the clinician to visualize wall thickening. Therefore, the authors seek in their method to preserve the brightening effect.The authors find that the proposed method offers better noise reduction than several existing methods as quantitatively evaluated by signal-to-noise ratio, bias-variance plots, and ejection fraction analysis as well as on tested clinical data.The proposed method mitigates for noise in cardiac gated SPECT images using a postreconstruction motion-compensated filtering approach. Visual as well as quantitative evaluation show considerable improvement in image quality.
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