Immunohistochemical characterization of glandular elements in glandular cardiac myxoma: Study of six cases

Nath, Devajit; Arava, Sudheer; Ray, Ruma; Bhoje, Amol; Saxena, Rahul; Chaudhary, Shilpi

doi:10.4103/ijpm.ijpm_225_16

Cited by 6 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The immunohistochemical profile of these acini in the presented case is quite intriguing. It is almost identical to the upper GIT epithelium, showing immunoreactivity for PAN-CK and CK7 while being negative for CK20 and CDX2 [ 3 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Up to our knowledge, including the presented case, forty-eight cases of glandular cardiac myxoma were reported in the English literature. Actually, glandular tissue is one of the different forms of tissues that can occur in cardiac myxomas, such as hematopoietic tissue, metaplastic bone, or thymic rests [ 2 , 3 , 5 , 7 ]. Glandular differentiation, however, is rare in this commonly diagnosed cardiac lesion, encountered in approximately 3% of all cardiac myxomas [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Identifying glandular elements in a cardiac myxoma as an integral component of the tumor is of paramount significance due to the resemblance of such elements to gastrointestinal (GIT) epithelium, being composed of acini lined by columnar cells and goblet cells capable of producing mucin just like colonic epithelium. Not only that but also the immunohistochemistry of these acini is almost identical to GIT epithelium [ 3 , 8 ]. Consequently, the presence of such glandular elements in a location outside the GIT, such as the heart, can lead to misinterpretation of the lesion as a metastatic adenocarcinoma [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Among these is the presence of glandular differentiation in rare cardiac myxomas. Ever since 1946, when Anderson and Dmytryk first described this change [ 2 ], only a few cases of “glandular cardiac myxomas” had been reported in the English literature (fewer than fifty) [ 3 ]. Herein, we report a case of left atrial myxoma with glandular differentiation, emphasizing its distinction from metastatic adenocarcinoma.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cardiac Myxoma: Typical Presentation but Unusual Histology

AlAhmadi

Alsafwani

Shawarby

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

Cardiac myxoma, a benign heart tumor, is the most common primary tumor of the heart. Glandular differentiation within these tumors is rare, occurring in approximately 3% of all cardiac myxomas. Its presence can complicate the diagnostic process. A 43-year-old Saudi male was referred with a two-month history of progressively increasing shortness of breath. Cardiovascular examination demonstrated a soft first heart sound with a plopping sound in the mitral area and a mid-diastolic murmur. A transthoracic echocardiogram revealed a large mass attached to the interatrial septum. A diagnosis of cardiac myxoma was made, and the patient underwent en bloc resection of the mass. Microscopic evaluation of the resected mass showed a neoplastic lesion with two components: first, a typical myxoma consisting of stellate and spindle cells in a myxomatous/hemorrhagic background; second, a glandular component consisting of separate, fused, and cribriform acini embedded within the myxomatous component. The acini were lined by a single row of columnar epithelial cells with basal nuclei and apical mucin. Occasional goblet cells were also identified. The postoperative period was uneventful, and on his recent follow-up in the clinic (nine months after the surgery), the patient is doing well with no complications. Herein, we emphasize the importance of accurately diagnosing such an entity, as it can be easily confused for a metastatic adenocarcinoma, especially in patients with a history of malignancy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiac Myxoma: Typical Presentation but Unusual Histology

AlAhmadi

Alsafwani

Shawarby

et al. 2021

Case Reports in Medicine

View full text Add to dashboard Cite

show abstract

“…In 2–5% of myxomas, areas of glandular differentiation are found. When present, this unusual morphologic variation typically involves only a small component of the tumour volume 1 , 3 , 4 . Awareness that myxomas may have glandular features is important to prevent a misdiagnosis of a cardiac metastases of adenocarcinoma 5 …”

Section: Introductionmentioning

confidence: 99%

Bi-atrial cardiac myxoma with glandular differentiation: a case report with detailed radiologic-pathologic correlation

Flint

Siegel

Bannykh

et al. 2018

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Introduction Myxoma is the most common cardiac benign tumour. While a typical myxoma is generally a straightforward diagnosis, some myxomas have unusual features that can make the diagnosis challenging. Glandular myxomas and metastatic adenocarcinomas, the most common type of metastatic carcinoma to the heart, can have very similar features. Case presentation We report a 60-year old man who presented with progressive shortness of breath on exertion. Echocardiography demonstrated a large heterogeneous, cystic left and right atrial mass. He was referred for surgery where a smooth and multilobulated left atrial mass was excised. Histopathological analysis with special stains revealed an unusual form of cardiac myxoma with extensive glandular differentiation. Discussion Cardiac myxomas can present with diverse clinical, radiological, and pathological features. Echocardiography is a modality of choice for diagnosis but can also miss small or multiple masses. Cardiac myxoma with glandular features is a rare type of myxoma. In our case, there was extensive glandular differentiation and the echocardiographic appearance provided clues for the unusual features of the tumour, suggesting a potential role for echocardiography in the detection and recognition of this morphologic histologic variation.

show abstract