Myxoma pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Pathophysiology
Gross Pathology
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A gelatinous tumor is attached by a narrow pedicle to the atrial septum. The myxoma has an irregular surface and nearly fills the left atrium.
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Left Atrial Myxoma
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Myxoma Embolus to Iliac Bifurcation: An embolized fragment of the tumor
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Atrial Myxoma: A calcified right atrial mass on the X ray of a 47-year-old man. Resection demonstrated a smooth-surfaced tumor. The gritty material seen microscopically on cut section was calcified and ossified myxoma.
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Myxoma: Gross natural color (outstanding) photo of intact large left atrial myxoma with atrium and left ventricle opened in usual way
Microscopic Pathology
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Cardiac myxoma with ossification: Note central area of bone surrounded by myxoma.
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Cardiac Myxoma: Gamna Bodies: A peculiar form of fibrosis with deposition of iron pigment, identical to that seen in the spleens of patients with sickle cell anemia, is not uncommon in myxoma.
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Cardiac Myxoma Common features at the interface with the atrial septum include lymphoid aggregates, smooth muscle bundles, and thick walled vessels which angiographically may look like neovascularization.
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Cardiac Myxoma The extramedullary hematopoiesis seen here is present in about 7 percent of cardiac myxomas.
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Cardiac Myxoma Glandular structures are seen in less than 5 percent of cases. In this example, they were limited to the base of the myxoma
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Cardiac Myxoma In this myxoma, glandular structures compose the majority of the lesion. Typical myxoma nests merge imperceptibly with glands. The differential diagnosis includes metastatic carcinoma; however, atypia and mitoses are absent.
