Cardiac tumors other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]

Overview

Cardiac Biopsy is recommended for the detection of specific cardiac tumors if the potential advantages outweigh the dangers. Quick histological identification permits prompt initiation of the right treatment. Cardiac Biopsy should be conducted by an experienced operator using fluoroscopy and transthoracic, transesophageal, or intracardiac echocardiography guidance to assure patient safety.

Cardiac Tumors Biopsy Findings

Biopsy findings associated with cardiac tumors include the following:
Cardiac Tumors Biopsy Findings
Tumor Biopsy Findings
Myxoma Hemorrhages, spindle or stellate cells, pseudovascular structure, myxoid matrix.
  • There may be dystrophic calcification present.
  • Immunohistochemical examination of PRKAR1A is a promising screening method for determining if myxomas form in Carney complex lesions.[1]
Cardiac Lipoma Histopathologically, a cardiac lipoma is constituted of
  • mature fat cells, fibrous connective tissue, and
  • vacuolated brown fat.[2]
Cardiac Fibroma Histologically, fibromas are predominantly made of:
  • Fibroblasts or collagen, with the characteristic "spindle cells."
  • Calcification of fibromas is especially prevalent among elderly people.[3]
Rhabdomyoma Cardiac rhabdomyomas are characterized by
  • classic spider cells, polygonal myocytes with conspicuous sarcoplasmic clearing.
  • Rhabdomyomas are formed of enlarged, vacuolated cardiomyocytes.[4]
Fibroelastomas
  • It consists of endocardium-coated fronds surrounding an avascular collagenous core.[2]
Mesothelioma Histopathology Mesothelioma cells can exhibit three different configurations,
  • namely largely epithelial, mostly fibrous (spindle cell), and biphasic (mixed).
  • Carcinoembryonic antigen (CEA) and positive mesothelial markers (calretinin and cytokeratins) may effectively distinguish mesotheliomas from pericardial metastases of adenocarcinoma.[5]
Cystic Tumor of the Atrioventricular Node The tumor is found on the right side of the central fibrous body, invading and squeezing the AV node histologically.
  • The lesions are packed by a mucoid  material and are bordered by epithelium, cytokeratin, and epithelial membrane antigen positive.[6]
Hemangioma Histologically characterized by:
  • small capillaries (capillary hemangioma), big vessels (cavernous hemangioma, the most frequent kind), or dysplastic vessels (cirsoid aneurysm).[2]
Hamartoma of Cardiac Myocytes Lesions are defined histologically by a
  • nodular cluster of enlarged, highly disordered cardiomyocytes.[7]
Undifferentiated Pleomorphic Sarcoma Histopathologic features of Undifferentiated Pleomorphic Sarcoma are
  • Typical spindle and polygonal (strap-like) cells filled with an eosinophilic cytoplasm
  • Desmin- and myoglobin-positive
  • CD68 negative[8]
Angiosarcoma Microscopically, angiosarcomas are composed of:
  • Actively growing, invading anaplastic cells originating from blood vessels and lining irregular blood-filled areas and malignant vascular tissue.
  • There are typically extensive areas of bleeding and necrosis inside the tumor.[2]

References

  1. ↑ Maleszewski JJ, Larsen BT, Kip NS, Castonguay MC, Edwards WD, Carney JA; et al. (2014). "PRKAR1A in the development of cardiac myxoma: a study of 110 cases including isolated and syndromic tumors". Am J Surg Pathol. 38 (8): 1079–87. doi:10.1097/PAS.0000000000000202. PMID 24618615.
  2. ↑ 2.0 2.1 2.2 2.3 Maleszewski JJ, Anavekar NS, Moynihan TJ, Klarich KW (2017). "Pathology, imaging, and treatment of cardiac tumours". Nat Rev Cardiol. 14 (9): 536–549. doi:10.1038/nrcardio.2017.47. PMID 28436488.
  3. ↑ Lamba G, Frishman WH (2012). "Cardiac and pericardial tumors". Cardiol Rev. 20 (5): 237–52. doi:10.1097/CRD.0b013e31825603e7. PMID 22447042.
  4. ↑ Beghetti M, Gow RM, Haney I, Mawson J, Williams WG, Freedom RM (1997). "Pediatric primary benign cardiac tumors: a 15-year review". Am Heart J. 134 (6): 1107–14. doi:10.1016/s0002-8703(97)70032-2. PMID 9424072.
  5. ↑ Nilsson A, Rasmuson T (2009). "Primary Pericardial Mesothelioma: Report of a Patient and Literature Review". Case Rep Oncol. 2 (2): 125–132. doi:10.1159/000228894. PMC 2918860. PMID 20740175.
  6. ↑ Moorjani N, Kuo J, Wilkins D (2004). "Left atrial phaeochromocytoma". Heart. 90 (11): e64. doi:10.1136/hrt.2004.041319. PMC 1768537. PMID 15486108.
  7. ↑ ElBardissi AW, Dearani JA, Daly RC, Mullany CJ, Orszulak TA, Puga FJ; et al. (2008). "Analysis of benign ventricular tumors: long-term outcome after resection". J Thorac Cardiovasc Surg. 135 (5): 1061–8. doi:10.1016/j.jtcvs.2007.10.048. PMID 18455585.
  8. ↑ Nakagawa Y, Ikeda U, Hirose M, Ubukata S, Katsuki TA, Kaminishi Y; et al. (2004). "Successful treatment of primary cardiac lymphoma with monoclonal CD20 antibody (rituximab)". Circ J. 68 (2): 172–3. doi:10.1253/circj.68.172. PMID 14745155.

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