In a patient with endocarditis due to Candida tropicalis echocardiograms from mitral valve vegetations were found to mimic the typical pattern of a left atrial myxoma. A mass was shown occupying the mitral orifice posterior to the anterior mitral leaflet; densities also appeared in the left atrium. Though these echocardiographic findings were consistent with the diagnosis of a left atrial myxoma, there were other distinctive differential diagnostic features. Other diagnostic possibilities must, therefore, be considered in the interpretation of echocardiograms which suggest left atrial tumour. (+info)
(2/1025) Symptomatic mitral myxomatous transformation in the elderly.
The clinical and pathological features of four patients with intractable heart failure, due to myxomatous change in the mitral valve, are described. It is suggested that this change may represent a response of ageing connective tissue to mechanical stress. (+info)
(3/1025) Primary right atrial angiosarcoma mimicking acute pericarditis, pulmonary embolism, and tricuspid stenosis.
A 29 year old white man presented to the emergency room with new onset pleuritic chest pain and shortness of breath. He was initially diagnosed as having viral pericarditis and was treated with non-steroidal anti-inflammatory drugs. A few weeks later he developed recurrent chest pain with cough and haemoptysis. Chest radiography, cardiac examination, transthoracic and transoesophageal echocardiography pointed to a mass that arose from the posterior wall of the right atrium, not attached to the interatrial septum, which protruded into the lumen of the right atrium causing intermittent obstruction of inflow across the tricuspid valve. Contrast computed tomography of the chest showed a right atrial mass extending to the anterior chest wall. The lung fields were studded with numerous pulmonary nodules suggestive of metastases. A fine needle aspiration of the pulmonary nodule revealed histopathology consistent with spindle cell sarcoma thought to originate in the right atrium. Immunohistochemical stains confirmed that this was an angiosarcoma. There was no evidence of extracardiac origin of the tumour. The patient was treated with chemotherapy and radiation. This case highlights the clinical presentation, rapid and aggressive course of cardiac angiosarcomas, and the diagnostic modalities available for accurate diagnosis. (+info)
(4/1025) Dystrophic calcification of the fetal myocardium.
Intramural cardiac masses were detected antenatally in three fetuses by echocardiography. The masses were initially thought to be rhabdomyomas. All three pregnancies were terminated and histology showed dystrophic calcification in all, with no evidence of tumour. Therefore, dystrophic calcification of the fetal myocardium may have a similar appearance to single or multiple rhabdomyomas. This should be considered when counselling parents after detection of masses in the fetal heart, particularly when considering the risk of associated tuberous sclerosis. (+info)
(5/1025) Primary cardiac Kaposi's sarcoma.
We report the clinical, laboratory, and necropsy findings in a 14-year-old boy with a primary Kaposi's sarcoma of the heart. Primary cardiac Kaposi's sarcoma and angiosarcoma are compared, and the pathogenesis of Kaposi's sarcoma is discussed. Relevant literature is briefly reviewed. (+info)
(6/1025) Localized pericarditis with calcifications mimicking a pericardial tumor.
A 62-year-old man was admitted with increasing palpitations. Radiography of the chest demonstrated a calcified mass. Magnetic resonance imaging revealed compression of the right ventricle by a tumor. At the time of cardiac catheterization, the coronary arteries were found not to supply blood flow of the mass, and no dip-and-plateau pattern was seen in the right ventricular pressure measurements. At the time of surgery, the mass was found to be a focal calcified thickening of the pericardium containing only pus. The thickening resembled an oval pericardial tumor. Microbiologic examination of the pus revealed Propionibacterium acnes. (+info)
(7/1025) In utero diagnosis of cardiac hemangioma.
Fetal cardiac hemangioma is rarely diagnosed prenatally. We present here a fetus with such a tumor diagnosed at 28 weeks' gestation. With the use of fetal echocardiography, a mixed echogenic mass protruding outward from the right atrial wall was observed. Moderate amounts of pericardial effusion were also found. Although no apparent blood flow signal was detected in the mass, fetal echocardiography showed signs suggestive of a hemangioma. Differential diagnosis, management and prognosis are discussed. (+info)
(8/1025) Expression of nm23 in the primary tumor and the metastatic regional lymph nodes of patients with gastric cardiac cancer.
Tumor recurrence and distant metastasis are major causes of treatment failure in gastric cardiac cancer (GCC). Rapid growth of tumor cells and reduced expression of nm23, a metastatic suppressor gene, in tumor cells have been suggested as two important mechanisms for disease progression of GCC. Therefore, to determine the prognostic value of nm23 expression in GCC, we used immunohistochemistry to examine the expression of nm23 in the pathological sections of both gastric cancer and metastatic lymph nodes from 24 stage III patients. Twenty-two patients had total gastrectomy, and two patients had proximal subtotal gastrectomy with a D2 dissection. Postoperative adjuvant therapy was provided, and the clinical responses were followed routinely. Clinical correlation was evaluated by chi2 with Fisher's exact test and survival by log-rank test. Our results show that the reduced nm23 expression in the primary tumor and in the nodal metastasis is the most useful marker for the poor prognosis of GCC following surgery. (+info)