This case report of a right atrial myxoma with atypical glandular histology provides ultrastructural evidence supporting the theory that atrial myxomas are true neoplasms rather than organized mural thrombi.
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Does not alter myxoma management; extends ultrastructural support for neoplastic origin but remains hypothesis-generating.
A 57-year-old black female presented with a 1-month of right-sided congestive heart failure and clinical evidence of pulmonic and tricuspid valvular stenosis and insufficiency. The echocardiographic examination and ventriculography demonstrated a large right atrial tumor interfering with the function of both right-sided valves. The patient underwent successful surgical resection of the tumor. Histologically, the tumor had cellular areas typical of myxoma, as well as glandular areas, a feature which has been described very rarely in this lesion. Electron microscopy of the glandular zones, which has never been reported previously, shown cells having essential homology with the usual myxoma elements. The atypical histopathology of this lesion supports the theory that atrial myxomas are true neoplasms, and are not derived from unusually organized mural thrombi.
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Frishman et al. (1979) studied this question.
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