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| Myxoma |
| Etiology |
•Unknown. |
| Pathogenesis |
•Unknown |
| Epidemiology |
•Occurs in adolescence and all higher age groups. •This is the most common primary neoplasm of the heart
in adults. |
| Clinical |
•The left atrial myxoma was the model of how a benign
tumor can kill by mechanical means in the days before
open heart surgery. It mimicked the diastolic murmur of
mitral stenosis, and was an unexpected autopsy finding. •Papillary myxomas may present as emboli to a limb or a
viscus. Pathology of excised embolus is diagnostic. •Some cases present with the non-specific effects of
interleukin-6 secreted by the tumor, which include
fever and malaise. |
| General Gross Description |
•90% occur in the atria with a 4:1 ratio of left:right
involvement. •Remainder can occur anywhere, including the heart
valves rarely. •Rarely multiple. •Typical lesion is a smooth glistening transluscent
firm or soft variegated mass with a broad base
attached to or near the fossa ovalis of the left
atrium. •Some examples have a papillary structure with a
villous surface. •Cut variegated surface jello-like in consistency with
fields of gray and dark red shades due to hemorrhages. |
| General Micro Description |
•A relatively sparsely cellular lesion with a
characteristic gel-like stroma of acid muco-
polysaccharides containing individual small cells
with sparse cytoplasm forming stellate protrusions
into the stroma. •Cells are thought to be benign
mesenchymal primitive anlage, which form other cellular
elements of the tumor, including endothelial cells
forming atypical vascular channels, fibroblasts, and
smooth muscles. •Hemorrhages are common. |
| Reference |
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 569.
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