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Difference between revisions of "Cardiac tumours"
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'''Cardiac tumours''' are rare buggers. | '''Cardiac tumours''' are rare buggers. | ||
== | ==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> | |||
==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. | ||
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Notes: | Notes: | ||
*If one is considering only valves - ''papillary fibroelastoma'' is No. 1. | *If one is considering only valves - ''papillary fibroelastoma'' is No. 1. | ||
Malignant heart tumours (in order of frequency):<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> | |||
#Undifferentiated. | |||
#Angiosarcoma. | |||
#Leiomyosarcoma. | |||
==Myxoma== | ==Myxoma== | ||
===General=== | ===General=== | ||
* | *Uncommon. | ||
*Clinical: may lead to cerebral infarction.<ref name=pmid3188128>{{cite journal |author=Knepper LE, Biller J, Adams HP, Bruno A |title=Neurologic manifestations of atrial myxoma. A 12-year experience and review |journal=Stroke |volume=19 |issue=11 |pages=1435-40 |year=1988 |month=November |pmid=3188128 |doi= |url=http://stroke.ahajournals.org/cgi/reprint/19/11/1435}}</ref> | *Clinical: may lead to cerebral infarction.<ref name=pmid3188128>{{cite journal |author=Knepper LE, Biller J, Adams HP, Bruno A |title=Neurologic manifestations of atrial myxoma. A 12-year experience and review |journal=Stroke |volume=19 |issue=11 |pages=1435-40 |year=1988 |month=November |pmid=3188128 |doi= |url=http://stroke.ahajournals.org/cgi/reprint/19/11/1435}}</ref> | ||
*Diagnosed by imaging. | *Diagnosed by imaging. | ||
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*Smooth surface. | *Smooth surface. | ||
=== | ===Microscopic=== | ||
Features:<ref name=pmid12006696/> | Features:<ref name=pmid12006696/> | ||
*Myxoid material - extra cellular (???) - '''key feature'''. | *Myxoid material - extra cellular (???) - '''key feature'''. | ||
| Line 44: | Line 52: | ||
*[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_high_mag.jpg Atrial myxoma - endothelial covering (wikimedia.org)]. | *[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_high_mag.jpg Atrial myxoma - endothelial covering (wikimedia.org)]. | ||
*[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_low_mag.jpg Atrial myxoma - sharp border (wikimedia.org)]. | *[http://commons.wikimedia.org/wiki/File:Atrial_myxoma_edge_low_mag.jpg Atrial myxoma - sharp border (wikimedia.org)]. | ||
==Fibroelastoma== | ==Fibroelastoma== | ||
| Line 83: | Line 71: | ||
*[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma.jpg Papillary fibroelastoma - low magnification (commons.wikimedia.org)]. | *[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma.jpg Papillary fibroelastoma - low magnification (commons.wikimedia.org)]. | ||
*[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma2.jpg Papillary fibroelastoma - intermediate magnification (commons.wikimedia.org)]. | *[http://commons.wikimedia.org/wiki/File:Papillary_fibroelastoma2.jpg Papillary fibroelastoma - intermediate magnification (commons.wikimedia.org)]. | ||
==Rhabdomyoma== | |||
*Very rare. | |||
*Benign. | |||
*Associated with [[tuberous sclerosis]].<ref name=pmid20721876>{{Cite journal | last1 = Yinon | first1 = Y. | last2 = Chitayat | first2 = D. | last3 = Blaser | first3 = S. | last4 = Seed | first4 = M. | last5 = Amsalem | first5 = H. | last6 = Yoo | first6 = SJ. | last7 = Jaeggi | first7 = ET. | title = Fetal cardiac tumors: a single-center experience of 40 cases. | journal = Prenat Diagn | volume = | issue = | pages = | month = Aug | year = 2010 | doi = 10.1002/pd.2590 | PMID = 20721876 }}</ref> | |||
==Rhabdomyosarcoma== | |||
See ''[[soft tissue tumours]]''. | |||
==Lipoma== | |||
*Like lipomas elsewhere in the body. | |||
DDx: | |||
*Lipomatous hypertrophy.<ref name=pmid20196664>{{Cite journal | last1 = Miller | first1 = DV. | last2 = Tazelaar | first2 = HD. | title = Cardiovascular pseudoneoplasms. | journal = Arch Pathol Lab Med | volume = 134 | issue = 3 | pages = 362-8 | month = Mar | year = 2010 | doi = | PMID = 20196664 }}</ref> | |||
==Cystic AV node tumour== | |||
===General=== | |||
*Super rare. | |||
*Usually 1-2 mm. | |||
===Gross=== | |||
*"Bump" in the ''triangle of Koch''. | |||
*Cystic spaces. | |||
===Microscopic=== | |||
Features: | |||
*Cystic spaces lined by epithelial cells. | |||
*+/-Psammoma bodies. (???) | |||
===IHC=== | |||
*CEA +ve. | |||
*EMA +ve. | |||
===Gross=== | ===Gross=== | ||