Cardiac tumors laboratory tests
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Template:Dj
Overview
Laboratory Findings
Template:Cardiac Tumors Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Template:Dj
Blood Investigations
- Some patients with cardiac tumors may have anemia, less commonly thrombocytopenia, increases in sedimentation rate, serum C-reactive protein level, or globulin level. These are nonspecific diagnostic anomalies.[1][2]
- Antimyolemmal antibodies could also be elevated. Antimyolemmal antibodies are significantly more prevalent in chronic pericardial effusion, perimyocarditis, and dilated cardiomyopathy patients than healthy controls.[3]
- Antiendothelial antibodies of the IgG type are detected in 86 percent of atrial myxoma patients. Endothelial cells are activated by Antiendothelial antibodies, leading to enhanced leukocyte adhesion, clotting activation, and vessel thrombosis.[4][3]
Imaging
- The CXR can detect cardiomegaly. A localized tumor prominence may or may not be present.
- On echocardiography, a massive, noncontractile, firm lump may be observed in the atrial or ventricular walls. It is more useful in diagnosing myxomas as compared to sarcomas.[5]
- Doppler ultrasonography measures of velocities can be used to calculate chamber pressures.[6]
- Transesophageal echocardiography (TEE) is appropriate for evaluating malignancies anticipated to include the atria, interatrial septum, superior vena cava, atrioventricular valves, and, to a minor degree, the ventricles.[5]
- CT and Cardiac MRI(CMR)are helpful for resectability evaluation.[5]
- PET can be utilized to detect cardiovascular spread in patients with metastatic malignancies and enables surgical treatment.[7]
- Imaging tests individually cannot determine if a heart tumor is benign or malignant; histologic assessment is required for a definite diagnosis.
Biopsy
- Minimally invasive techniques such as
- cytologic assessment of pericardial/pleural fluids,
- echo-guided percutaneous cardiac biopsy, and
- echo-guided transvenous cardiac biopsy can be used to diagnose tissue.
- The false-negative rate of these techniques can be substantial.
- Therefore, mediastinoscopy or even thoracotomy may be required for more invasive tumor biopsies for a definitive diagnosis.
References
- ↑ Bussani R, Castrichini M, Restivo L, Fabris E, Porcari A, Ferro F; et al. (2020). "Cardiac Tumors: Diagnosis, Prognosis, and Treatment". Curr Cardiol Rep. 22 (12): 169. doi:10.1007/s11886-020-01420-z. PMC 7547967 Check
|pmc=value (help). PMID 33040219 Check|pmid=value (help). - ↑ Pinede L, Duhaut P, Loire R (2001). "Clinical presentation of left atrial cardiac myxoma. A series of 112 consecutive cases". Medicine (Baltimore). 80 (3): 159–72. doi:10.1097/00005792-200105000-00002. PMID https://pubmed.gov/11388092 Check
|pmid=value (help). - ↑ 3.0 3.1 Karatolios K, Pankuweit S, Richter A, Ruppert V, Maisch B (2016). "Anticardiac Antibodies in Patients with Chronic Pericardial Effusion". Dis Markers. 2016: 9262741. doi:10.1155/2016/9262741. PMC 4749782. PMID 26941472.
- ↑ Belizna C, Duijvestijn A, Hamidou M, Tervaert JW (2006). "Antiendothelial cell antibodies in vasculitis and connective tissue disease". Ann Rheum Dis. 65 (12): 1545–50. doi:10.1136/ard.2005.035295. PMC 1798473. PMID 16569688.
- ↑ 5.0 5.1 5.2 Gilkeson RC, Chiles C (2003). "MR evaluation of cardiac and pericardial malignancy". Magn Reson Imaging Clin N Am. 11 (1): 173–86, viii. doi:10.1016/s1064-9689(02)00047-8. PMID 12797518.
- ↑ Araoz PA, Eklund HE, Welch TJ, Breen JF (1999). "CT and MR imaging of primary cardiac malignancies". Radiographics. 19 (6): 1421–34. doi:10.1148/radiographics.19.6.g99no031421. PMID 10555666.
- ↑ García JR, Simo M, Huguet M, Ysamat M, Lomeña F (2006). "Usefulness of 18-fluorodeoxyglucose positron emission tomography in the evaluation of tumor cardiac thrombus from renal cell carcinoma". Clin Transl Oncol. 8 (2): 124–8. doi:10.1007/s12094-006-0169-7. PMID 16632427.