Cardiac tumors laboratory tests

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

Overview

Biopsy is required for definitive diagnosis, echocardiogram is a preliminary diagnosing tool for most cardiac tumors. Certain cardiac tumors release inflammatory cytokines which can lead to increased blood inflammatory markers like ESR, CRP.

Laboratory Findings

Blood Investigations

Imaging

  • The CXR can detect cardiomegaly. A localized tumor prominence may or may not be present.
  • On echocardiography, a massive, noncontractile, firm lump may be observed in the atrial or ventricular walls. It is more useful in diagnosing myxomas as compared to sarcomas.[5]
  • Doppler ultrasonography measures of velocities can be used to calculate chamber pressures.[6]
  • Transesophageal echocardiography (TEE) is appropriate for evaluating malignancies anticipated to include the atria, interatrial septum, superior vena cava, atrioventricular valves, and, to a minor degree, the ventricles.[5]
  • CT and Cardiac MRI(CMR)are helpful for resectability evaluation.[5]
  • PET can be utilized to detect cardiovascular spread in patients with metastatic malignancies and enables surgical treatment.[7]
    • Imaging tests individually cannot determine if a heart tumor is benign or malignant; histologic assessment is required for a definite diagnosis.

Biopsy

  • Biopsy provides the definitive diagnosis and can be performed either as a:
  • Minimally invasive techniques such as
    • cytologic assessment of pericardial/pleural fluids,
    • echo-guided percutaneous cardiac biopsy, and
    • echo-guided transvenous cardiac biopsy can be used to diagnose tissue.
  • Or, mediastinoscopy or thoracotomy for more invasive tumor biopsies for a definitive diagnosis.[8]
  • The false-negative rate of Minimally Invasive techniques can be substantially high.[8]

References

  1. Bussani R, Castrichini M, Restivo L, Fabris E, Porcari A, Ferro F; et al. (2020). "Cardiac Tumors: Diagnosis, Prognosis, and Treatment". Curr Cardiol Rep. 22 (12): 169. doi:10.1007/s11886-020-01420-z. PMC 7547967 Check |pmc= value (help). PMID 33040219 Check |pmid= value (help).
  2. Pinede L, Duhaut P, Loire R (2001). "Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases". Medicine (Baltimore). 80 (3): 159–72. doi:10.1097/00005792-200105000-00002. PMID https://pubmed.gov/11388092 Check |pmid= value (help).
  3. 3.0 3.1 Karatolios K, Pankuweit S, Richter A, Ruppert V, Maisch B (2016). "Anticardiac Antibodies in Patients with Chronic Pericardial Effusion". Dis Markers. 2016: 9262741. doi:10.1155/2016/9262741. PMC 4749782. PMID 26941472.
  4. Belizna C, Duijvestijn A, Hamidou M, Tervaert JW (2006). "Antiendothelial cell antibodies in vasculitis and connective tissue disease". Ann Rheum Dis. 65 (12): 1545–50. doi:10.1136/ard.2005.035295. PMC 1798473. PMID 16569688.
  5. 5.0 5.1 5.2 Gilkeson RC, Chiles C (2003). "MR evaluation of cardiac and pericardial malignancy". Magn Reson Imaging Clin N Am. 11 (1): 173–86, viii. doi:10.1016/s1064-9689(02)00047-8. PMID 12797518.
  6. Araoz PA, Eklund HE, Welch TJ, Breen JF (1999). "CT and MR imaging of primary cardiac malignancies". Radiographics. 19 (6): 1421–34. doi:10.1148/radiographics.19.6.g99no031421. PMID 10555666.
  7. García JR, Simo M, Huguet M, Ysamat M, Lomeña F (2006). "Usefulness of 18-fluorodeoxyglucose positron emission tomography in the evaluation of tumor cardiac thrombus from renal cell carcinoma". Clin Transl Oncol. 8 (2): 124–8. doi:10.1007/s12094-006-0169-7. PMID 16632427.
  8. 8.0 8.1 Lamba G, Frishman WH (2012). "Cardiac and pericardial tumors". Cardiol Rev. 20 (5): 237–52. doi:10.1097/CRD.0b013e31825603e7. PMID 22447042.

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