Clinicopathologic Study and DNA Analysis of 37 Cardiac Myxomas

Acebo, Elvira; Val-Bernal, J. Fernando; Gómez-Román, Javier; Revuelta, José M.

doi:10.1378/chest.123.5.1379

Cited by 112 publications

(121 citation statements)

References 25 publications

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“…[8][9][10][11][12][13][14][15] The morphologic studies, such as those on vascular proliferation, hyaline formation, congestive areas, inflammation, hemorrhagic foci, calcification, and multiple giant cells, were not statistically significant for clinical presentations as in previous reports. [8][9][10][11][12] Moreover, the findings of apoptotic changes in cardiac myxoma were compatible with previous studies. 13,28 Apoptosis, commonly referred to as programmed cell death, involves the continuous destruction of nonfunctional cells.…”

Section: Discussioncontrasting

confidence: 44%

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Caspase-3-dependent apoptosis in cardiac myxoma: not associated with human papillomavirus or Epstein–Barr virus

et al. 2005

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Cardiac myxoma is the most common tumor of the heart, has a variable clinical presentation and immunohistochemical profile. Viral infections, such as herpes simplex virus, human papillomavirus (HPV), and Epstein-Barr virus (EBV), may play an important role in the causes of cardiac myxoma. This investigation will demonstrate caspase-3-dependent apoptosis in cardiac myxoma without HPV or EBV infection. This study included 15 patients with cardiac myxoma, who were treated with surgical excision of the lesion. Data were collected on detailed clinical parameters. Terminal deoxynucleotidyl transferase nick-end labeling assay, electrophoresis, and caspase-3 immunohistochemical studies were performed to characterize apoptosis. Genechip containing 39 subtypes was used to elucidate HPV; and polymerase chain reaction to detect LMP-1 gene of EBV. The patient population comprised of eight (53%) women and seven (47%) men. The mean age of patient participants was 45 years, with an age range of 30-70 years. All patient cases were sporadic myxomas rather than familial myxomas. The patient presentations included dyspnea (53%), asymptomatic (27%), stroke (7%), chest pain (7%), and fever (7%). All lesions were located in the left atrium. The individual patient cases of myxoma did not differ in location or clinical event in terms of pathological scores, such as vascular proliferation, inflammation, cellularity, hyaline, calcification, or thrombosis. Cardiac myxoma is characterized by apoptosis through caspase-dependent pathway. HPV or EBV was not detected in any of the study patient samples. In conclusion, no viral genomes of HPV or EBV were detected in these 15 patients. This study demonstrates that caspase-3-dependent apoptosis in cardiac myxoma is not dependent on concurrence of previous HPV and/or EBV infection.

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Section: Discussioncontrasting

confidence: 44%

“…7 Myxoma is the most common benign neoplasm of the heart. [8][9][10][11][12][13][14][15] Cardiac myxoma is associated with many mucopolysaccharidic matrices, including glycosaminoglycans 14,15 and proteoglycans. These glycoproteins may serve as receptors for the entry of HSV-1, 16,17 human papillomavirus (HPV), 18 and EBV.…”

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confidence: 99%

Caspase-3-dependent apoptosis in cardiac myxoma: not associated with human papillomavirus or Epstein–Barr virus

et al. 2005

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“…Multinucleate myxoma cells were present in excised tissue from 14 of the 17 myxoma cases in this study. HSV-1 antigen was present mainly in myxoma cells, found previously to produce interleukin 6 (IL-6) 28 and vascular endothelial growth factor (VEGF) 29 as do other HSV-1-infected cell types. High serum concentration of IL-6, thought to be responsible for the constitutional symptoms and immunological abnormalities in patients with atrial myxoma, 30 is also involved in HSV-1 reactivation from the neurons of sensory ganglia and protects mice from otherwise lethal HSV-1 infection.…”

Section: Discussionmentioning

confidence: 99%

Herpes Simplex Virus Type 1 Infection Associated with Atrial Myxoma

Pan

et al. 2003

The American Journal of Pathology

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Some findings suggest an infectious factor in cardiac myxoma and certain histopathological features indicate herpes simplex virus type 1 (HSV-1) infection. We hypothesized that HSV-1 may be involved in the pathogenesis of cardiac myxoma. Paraffin-embedded tissue samples from 17 patients with atrial myxoma were investigated for HSV-1 antigen by immunohistochemistry and viral genomic DNA by nested polymerase chain reaction. The histogenesis and oncogenesis of atrial myxoma were assessed by the expression of calretinin, Ki67, and p53 protein, respectively. Autopsy myocardial samples, including endocardium from 12 patients who died by accident or other conditions, were used for comparison. HSV-1 antigen was detected in atrial myxoma from 12 of 17 patients: 8 of these 12 samples were positive also for HSV-1 DNA. No HSV-1 antigen or DNA was found in tissue from the comparison group. Antigens of HSV-2, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus were not found in atrial myxoma. Calretinin was found in myxoma cells of all 17 cases but Ki67 was present only in smooth muscle cells or infiltrating cells in some cases. p53 was not detectable in any myxoma. Most infiltrating cells were cytotoxic T lymphocytes. These data suggest that HSV-1 infection is associated with some cases of sporadic atrial myxoma and that these may result from a chronic inflammatory lesion of endocardium. Although benign, atrial myxoma is the most common primary cardiac tumor, with an incidence of about one per million population per year and a recurrence rate of 2% to 3%.

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“…Of them, 54 reports describing CM without any glandular components, or narrating glandular differentiation of CM without patient information, such as review articles, book chapters and majority of the web pages, were excluded from the statistical analysis of this study. Alternative exclusion criteria included duplicate publications [20,26,28,46,48], and original articles with only patient number [2,9,35], or even with no patient number [7,13,66,80] of glandular CM without patient information, with 3 intracardiac heterotopia of epithelium [6,11,51], and describing a bone metastasis of glandular CM, however, the in situ CM did not show any glandular components [69] [18]) were included, with 99 patients with a glandular CM (a total of 100 cases including the present patient) representing 7.4% of the 1,351 CM patients under investigation. Of the 100 patients, 24 were males and 39 were females with a male-to-female ratio of 1:1.63, while gender could not be tracked in 37 patients.…”

Section: Discussionmentioning

confidence: 99%