Giant left atrial myxoma – literature review and case presentation

Figures

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  Figure 1. (a and b) Cerebral MRI, axial T2 FLAIR sequences revealed right ischemic cerebellar stroke and left hemispheric stroke. FLAIR: Fluid-attenuated inversion recovery; MRI: Magnetic resonance imaging

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  Figure 2. (a and b) Presurgical 2D transthoracic echocardiography showed a cardiac mass located in the left atrium, with imprecise margins, attached to the interatrial septum. 2D: Two-dimensional

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  Figure 3. (a and b) Thoracoabdominal–pelvic CT scan showed a tumoral mass in the left atrium with minimal enhancement after contrast administration, splenic lesion suggestive of splenic infarction. CT: Computed tomography

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  Figure 4. (a and b) Macroscopic aspect of the tumoral mass: gelatinous and polylobulated aspect of the myxoma (I); the tumoral mass is pediculated, with origin at the level of the interatrial septum – fragment resected from the interatrial septum (II); the presence of isolated secondary thrombi (III) on the tumor surface

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  Figure 5. (a) Defining cellular characteristics are observed. Predominantly hypocellular areas with rare hypercellular foci composed of bland, stellate, ovoid or plump spindle myxoma cells, showing no mitotic activity with variable numbers of inflammatory cells in the background. Cells are embedded in a slightly basophilic matrix; occasional blood vessels with focal hemorrhage are also seen. (b) Larger, thick-walled vessels are regularly seen at the implantation site (or base) of the lesion, occasionally with tumor emboli such as the one depicted in the microphotograph. (c) Myxoma cells (also called lepidic cells) are marked with anti-calretinin antibodies; somewhat more cellular areas are observed here. HE staining: (a and b) ×100. DAB chromogen, immunohistochemical staining: (c) ×200. DAB: 3,3’-Diaminobenzidine; HE: Hematoxylin–Eosin

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  Figure 6. (a and b) Postsurgical 2D transthoracic echocardiography showed the absence of the tumoral mass, no shunt at the site of the interatrial septum and a competent mitral valve. 2D: Two-dimensional