HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Guest Access | Sign In via User Name/Password

This Article Full Text Free Full Text (PDF) Free Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (21) Citing Articles via Google Scholar Google Scholar Articles by Acebo, E. Articles by Revuelta, J. M. Search for Related Content PubMed PubMed Citation Articles by Acebo, E. Articles by Revuelta, J. M.

Clinicopathologic Study and DNA Analysis of 37 Cardiac Myxomas^*

A 28-Year Experience

^* From the Department of Anatomical Pathology (Drs. Acebo, Val-Bernal, and Gómez-Román) and the Service of Cardiovascular Surgery (Dr. Revuelta), Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, Santander, Spain.

Correspondence to: J. Fernando Val-Bernal, MD, PhD, Departamento de Anatomía Patológica, Hospital Universitario Marqués de Valdecilla, Avda Valdecilla 1, E-39008 Santander, Spain; e-mail: apavbj{at}humv.es

Purpose: This study was performed to identify morphologic features of cardiac myxomas related to embolism and to provide a better understanding of the biology of these tumors, mainly in relation to their interleukin (IL)-6 expression and DNA content.

Patients and methods: A total of 37 cardiac myxomas were reviewed retrospectively in a clinicopathologic study that included the correlation of echocardiographic and pathologic findings in 25 cases, together with immunohistochemical evaluation of IL-6 expression and flow cytometric DNA analysis of 35 tumors.

Results: There were 24 female patients and 13 male patients. The mean (± SD) age was 52 ± 15 years. Fifty-four percent of patients presented with dyspnea, 51% presented with increased erythrocyte sedimentation rate (ESR), and 27% presented with embolic episodes, which were significantly associated with villous surface tumors. Atrial fibrillation was registered in 19% of patients and was significantly associated with large left atrial myxomas. Echocardiography proved to be a reliable method for preoperative diagnosis and for predicting tumor size and morphology. There was no perioperative mortality or long-term recurrences. The frequency of early surgical complications was associated with a longer mean ischemic time. Seventeen percent of tumors had abnormal DNA content, and 74% of tumors showed immunohistochemical expression of IL-6. Neither of these factors showed a significant association with embolism or constitutional illness.

Conclusions: Villous surface myxomas are related to embolism, and large left atrial tumors are related to atrial fibrillation. Echocardiography is a reliable method with which to predict tumor size and morphology. Myxoma cells usually express IL-6, and some tumors have abnormal cellular DNA content. Surgical excision of the tumor is a safe and effective treatment.

Key Words: cardiac myxoma • clinical characteristics • flow cytometry • histopathologic finding • immunohistochemistry • interleukin-6

This article has been cited by other articles:

				N. Scott, J. P. Veinot, and K.-L. Chan Symptoms in Cardiac Myxoma Chest, December 1, 2003; 124(6): 2408 - 2408. [Full Text] [PDF]

				Y. Li, Z. Pan, Y. Ji, M. Sheppard, D. J. Jeffries, L. C. Archard, and H. Zhang Herpes Simplex Virus Type 1 Infection Associated with Atrial Myxoma Am. J. Pathol., December 1, 2003; 163(6): 2407 - 2412. [Abstract] [Full Text]