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atrial myxoma

Friday 13 January 2006

atrial myxoma

PO

Images

- macroscopy

- microscopy

Digital cases

- JRC:389 : atrial myxoma.
- JRC:14722 : atrial myxoma.
- JRC:14792 : atrial myxoma.
- JRC:18351 : atrial myxoma.
- JRC:18352 : atrial myxoma.
- JRC:18344 : atrial myxoma.
- JRC:19084 : atrial myxoma.
- JRC:19197 : atrial myxoma.

Microscopy

- Complex structures resembling cords, nests, rings or poorly formed glands, often surrounding blood vessels
- Composed of stellate or globular myxoma cells with abundant eosinophilic cytoplasm, indistinct cell borders, oval nucleus with open chromatin and indistinct nuclei
- Abundant mucopolysaccharide (myxoid) ground substance containing chondroitin sulfate and hyaluronic acid (Life Sci 2003;73:849)
- Usually inflammation, hemorrhage
- Often more cellular and mitotic activity near surface
- Variable fibrosis (41%),
- calcification (20%),
- Gamna-Gandy bodies (17%, identical to those in spleen of sickle cell anemia patients),
- ossification (8%),
- extramedullary hematopoiesis (7%, more common in children),
- mucin-forming glands (3%, Indian Heart J 2003;55:182),
- atypia (3%),
- thymic rests (1%)

Differential diagnosis

- Left atrial appendage thrombus
- Metastatic carcinoma: if myxoma has glandular structures; carcinoma has anaplasia, mitotic activity
- Mural myxoid thrombi: no nests, cords or rings, calretinin negative
- Myxoid sarcoma
- Papillary fibroelastoma: on valve cusps, avascular papillary fronds

Variants

- familial recurrent atrial myxoma

See also

- cardiac myxoma
- cardiac tumors
- myxomas and myxoid tumors
- atrial tumors

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