Cardiac tumors echocardiography or ultrasound

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dheeraj Makkar, M.D.[2]

Overview

  • Echocardiography is a readily available, mobile, and economic imaging technique that provides the initial information about the origins of a cardiac mass. The position, mobility, adherence, and shape of a mass can help establish whether it is benign or malignant.

Echocardiography findings in Cardiac tumors

  • Echocardiography may be helpful in the diagnosis of cardiac tumors. Findings on an echocardiography suggestive of different cardiac tumors include:
Echocardiographic Features of Cardiac Tumors
Tumor Findings
Myxoma Myxoma appears as a heterogeneous, dynamic mass with one of two fundamental morphologies
  • Polypoid myxomas have a bigger size, smooth exterior and a jagged center from hemorrhage and necrosis.
  • Papillary myxomas are often narrower and have an elongated look with numerous villi.[1]
Papillary Fibroelastoma Echocardiographic characteristics
  • are tiny size, autonomous movement, and endocardial adherence.
  • The margins seem stippled or glistening, particularly on TEE, due to agitation at the tumor–blood contact caused by finger-like extensions.[2]
Rhabdomyoma On the echocardiography,
  • they may look like tiny, well-circumscribed (many) clusters or a pedunculated bulge in the heart cavity.
  • They manifest brighter than the surrounding tissue with myocardial embedding.[3]
Fibroma They typically present as
  • precise, well-defined, noncontractile, compact, and substantially echogenic tumors inside the myocardial tissue on echocardiography.
  • Calcification could also develop.
Lipoma Lipomas are often
  • large, stationary, devoid of a pedicle, and well-contained on echocardiography.
  • They are uniform and calcification-free, hyperechoic in the myocardial cavity but hypoechoic in the pericardium.[4]
Hemangioma Because hemangiomas are composed of distended vascular vessels, they exhibit on echocardiography as an echogenic mass with echolucencies.
  • They can be present in the endocardium, myocardium, epicardium, or pericardium and are typically observed in the free wall of the right ventricle or the lateral wall of the left ventricle.[4]
Lymphoma Lymphomas can emerge as
  • uniform, penetrating aggregates that cause 'wall stiffening' and limiting hemodynamics or as granular masses that penetrate the cardiac chamber, particularly the right atrium on echocardiography.[5]
Angiosarcoma They appear on echocardiography
  • as lobulated heterogeneous aggregates with necrosis or bleeding.
  • They lack a stalk, which distinguishes them from Myxomas and Papillary Fibroelastomas.
  • Due to the presence of spindle cells, contrast echocardiography may not always detect a considerable increase, even when vascular.[4]
Mesothelioma Often, echocardiography
  • demonstrates a pericardial effusion and a tumor surrounding the heart; a distinct lesion might not be detected.[6]

References

  1. Lee VH, Connolly HM, Brown RD (2007). "Central nervous system manifestations of cardiac myxoma". Arch Neurol. 64 (8): 1115–20. doi:10.1001/archneur.64.8.1115. PMID 17698701.
  2. Klarich KW, Enriquez-Sarano M, Gura GM, Edwards WD, Tajik AJ, Seward JB (1997). "Papillary fibroelastoma: echocardiographic characteristics for diagnosis and pathologic correlation". J Am Coll Cardiol. 30 (3): 784–90. doi:10.1016/s0735-1097(97)00211-8. PMID 9283541.
  3. Smythe JF, Dyck JD, Smallhorn JF, Freedom RM (1990). "Natural history of cardiac rhabdomyoma in infancy and childhood". Am J Cardiol. 66 (17): 1247–9. doi:10.1016/0002-9149(90)91109-j. PMID 2239731.
  4. 4.0 4.1 4.2 Mankad R, Herrmann J (2016). "Cardiac tumors: echo assessment". Echo Res Pract. 3 (4): R65–R77. doi:10.1530/ERP-16-0035. PMC 5292983. PMID 27600455.
  5. Miguel CE, Bestetti RB (2011). "Primary cardiac lymphoma". Int J Cardiol. 149 (3): 358–63. doi:10.1016/j.ijcard.2010.02.016. PMID 20227122.
  6. Grebenc ML, Rosado de Christenson ML, Burke AP, Green CE, Galvin JR (2000). "Primary cardiac and pericardial neoplasms: radiologic-pathologic correlation". Radiographics. 20 (4): 1073–103, quiz 1110-1, 1112. doi:10.1148/radiographics.20.4.g00jl081073. PMID 10903697.

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