Difference between revisions of "Cardiac tumours"
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'''[[Heart|Cardiac]] tumours''' are rare buggers. They provide some work for cardiac surgeons. | '''[[Heart|Cardiac]] tumours''' are rare buggers. They provide some work for cardiac surgeons. | ||
=Most common malignant= | |||
*Metastases - most common cardiac tumour; 1:~100 primary tumours:secondary tumours.<ref name=pmid20472615>{{Cite journal | last1 = Castillo | first1 = JG. | last2 = Silvay | first2 = G. | title = Characterization and management of cardiac tumors. | journal = Semin Cardiothorac Vasc Anesth | volume = 14 | issue = 1 | pages = 6-20 | month = Mar | year = 2010 | doi = 10.1177/1089253210362596 | PMID = 20472615 }}</ref> | *Metastases - most common cardiac tumour; 1:~100 primary tumours:secondary tumours.<ref name=pmid20472615>{{Cite journal | last1 = Castillo | first1 = JG. | last2 = Silvay | first2 = G. | title = Characterization and management of cardiac tumors. | journal = Semin Cardiothorac Vasc Anesth | volume = 14 | issue = 1 | pages = 6-20 | month = Mar | year = 2010 | doi = 10.1177/1089253210362596 | PMID = 20472615 }}</ref> | ||
=Primary heart tumours= | |||
*Approximately 10% of resected (primary) cardiac tumours are malignant.<ref name=pmid18350921>{{cite journal |author=Burke A |title=Primary malignant cardiac tumors |journal=Semin Diagn Pathol |volume=25 |issue=1 |pages=39-46 |year=2008 |month=February |pmid=18350921 |doi= |url=}}</ref> | *Approximately 10% of resected (primary) cardiac tumours are malignant.<ref name=pmid18350921>{{cite journal |author=Burke A |title=Primary malignant cardiac tumors |journal=Semin Diagn Pathol |volume=25 |issue=1 |pages=39-46 |year=2008 |month=February |pmid=18350921 |doi= |url=}}</ref> | ||
**90% are sarcomas. | **90% are sarcomas. | ||
| Line 25: | Line 25: | ||
*According to WMSP:<ref name=Ref_WMSP135>{{Ref WMSP|135}}</ref> Most common primary malignant tumour of the heart = angiosarcoma. | *According to WMSP:<ref name=Ref_WMSP135>{{Ref WMSP|135}}</ref> Most common primary malignant tumour of the heart = angiosarcoma. | ||
=Specific entities= | |||
==Cardiac myxoma== | ==Cardiac myxoma== | ||
===General=== | ===General=== | ||
| Line 124: | Line 125: | ||
*EMA +ve. | *EMA +ve. | ||
=See also= | |||
*[[Heart]]. | *[[Heart]]. | ||
*[[Valvular heart disease]]. | *[[Valvular heart disease]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Cardiovascular pathology]] | [[Category:Cardiovascular pathology]] | ||
Revision as of 02:04, 23 October 2011
Cardiac tumours are rare buggers. They provide some work for cardiac surgeons.
Most common malignant
- Metastases - most common cardiac tumour; 1:~100 primary tumours:secondary tumours.[1]
Primary heart tumours
- Approximately 10% of resected (primary) cardiac tumours are malignant.[2]
- 90% are sarcomas.
- 10% are lymphomas.
In order of frequency:
Notes:
- If one is considering only valves - papillary fibroelastoma is No. 1.
Malignant heart tumours (in order of frequency):[1]
- Undifferentiated.
- Angiosarcoma.
- Leiomyosarcoma.
Note:
- According to WMSP:[3] Most common primary malignant tumour of the heart = angiosarcoma.
Specific entities
Cardiac myxoma
General
- Uncommon.
- Clinical: may lead to cerebral infarction.[4]
- Diagnosed by imaging.
- May be familial, i.e. Carney complex (AKA NAME syndrome, AKA LAMB syndrome).[5]
- NAME = Nevi, Atrial myxoma, Myxoid neurofibroma, and Ephelides (freckles[6]).
- LAMB = Lentigines, Atrial myxomas, Mucocutaneous myxomas, Blue nevi.
Most common presentations:[4]
- Dyspnea - 45%.
- Neurologic symptoms 36%.
Gross
Location:[4]
- Usually atrial.
- Usually left side.
Features:[7]
- Lobular surface.
- Smooth surface.
Microscopic
Features:[7]
- Myxoid material - extra cellular (???) - key feature.
- Calcified elastic fibers - gamna bodies.
- Hemorrhage common.
- Often covered by endothelium.
Images:
- Atrial myxoma (wikimedia.org).
- Atrial myxoma - endothelial covering (wikimedia.org).
- Atrial myxoma - sharp border (wikimedia.org).
Papillary fibroelastoma
- AKA fibroelastoma.
General
- Usually an incidental finding.
Gross
- Friable appearing.
- Yellow.
- Typically on free edge.
Microscopic
Features:[8]
- Braching papillary fronds which are:
- Composed of collagen, and
- Avascular.
- +/-Elastic tissue.
- Surrounded by:
- Endothelium, and
- Mucopolysaccharide.
Micrographs:
- Papillary fibroelastoma - low magnification (commons.wikimedia.org).
- Papillary fibroelastoma - intermediate magnification (commons.wikimedia.org).
Cardiac rhabdomyoma
Main article: Rhabdomyoma
- Very rare.
- Benign.
- Associated with tuberous sclerosis.[9]
Rhabdomyosarcoma
See soft tissue tumours.
Lipoma
Main article: Adipocytic tumours
- Like lipomas elsewhere in the body.
- Usually location: left ventricle, subendocardial.[3]
DDx:
- Lipomatous hypertrophy.[10]
Cystic tumour of the atrioventricular nodal region
General
- Super rare.[11]
- Usually 1-2 mm.
- May cause sudden cardiac death.[12]
Gross
- "Bump" in the triangle of Koch.
- Cystic spaces.
Microscopic
Features:[12]
- Cystic spaces lined single layer of epithelial cells.
- +/-Focal mononuclear inflammation.
- +/-Psammoma bodies.
Images:
IHC
- CEA +ve.
- EMA +ve.
See also
References
- ↑ 1.0 1.1 Castillo, JG.; Silvay, G. (Mar 2010). "Characterization and management of cardiac tumors.". Semin Cardiothorac Vasc Anesth 14 (1): 6-20. doi:10.1177/1089253210362596. PMID 20472615.
- ↑ Burke A (February 2008). "Primary malignant cardiac tumors". Semin Diagn Pathol 25 (1): 39-46. PMID 18350921.
- ↑ 3.0 3.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 135. ISBN 978-0781765275.
- ↑ 4.0 4.1 4.2 Knepper LE, Biller J, Adams HP, Bruno A (November 1988). "Neurologic manifestations of atrial myxoma. A 12-year experience and review". Stroke 19 (11): 1435-40. PMID 3188128. http://stroke.ahajournals.org/cgi/reprint/19/11/1435.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 135. ISBN 978-0781765275.
- ↑ URL: http://emedicine.medscape.com/article/1119293-overview. Accessed on: 7 January 2011.
- ↑ 7.0 7.1 Grebenc ML, Rosado-de-Christenson ML, Green CE, Burke AP, Galvin JR (2002). "Cardiac myxoma: imaging features in 83 patients". Radiographics 22 (3): 673-89. PMID 12006696. http://radiographics.rsna.org/content/22/3/673.long.
- ↑ URL: http://www.pathologyoutlines.com/hearttumor.html. Accessed on: 16 May 2011.
- ↑ Yinon, Y.; Chitayat, D.; Blaser, S.; Seed, M.; Amsalem, H.; Yoo, SJ.; Jaeggi, ET. (Aug 2010). "Fetal cardiac tumors: a single-center experience of 40 cases.". Prenat Diagn. doi:10.1002/pd.2590. PMID 20721876.
- ↑ Miller, DV.; Tazelaar, HD. (Mar 2010). "Cardiovascular pseudoneoplasms.". Arch Pathol Lab Med 134 (3): 362-8. PMID 20196664.
- ↑ Kaminishi, Y.; Watanabe, Y.; Nakata, H.; Shimokama, T.; Jikuya, T. (Jan 2002). "Cystic tumor of the atrioventricular nodal region.". Jpn J Thorac Cardiovasc Surg 50 (1): 37-9. PMID 11855098.
- ↑ 12.0 12.1 Paniagua, JR.; Sadaba, JR.; Davidson, LA.; Munsch, CM. (Apr 2000). "Cystic tumour of the atrioventricular nodal region: report of a case successfully treated with surgery.". Heart 83 (4): E6. PMID 10722558.