59 years old female presented with dyspnea with
exercise. Her chest x-ray showed possible left atrial
appendage enlargement. Echocardiogram was consistent
with a left atrial myxoma.
staining (Figures A, B, C & D) shows numerous fusiform, rounded and stellate lipidic cells in a
background of abundant myxoid matrix (mucopolysacarides)
infiltrated by scattered inflammatory cells. The myxoma
cells have eosinophilic cytoplasm with large vacuoles
and round to oval nuclei, with some cells arranged in
layers to form vasoformative rings (Figure C, arrow).
Scattered hemosiderin laden macrophages are also
Figure E is
another case showing the gross appearance of these tumors
with a multilobulated smooth surface, light tan and
light yellow translucent parenchyma with patchy
hemorrhage. These tumors are loosely embedded in the
myocardial parenchyma and are easily enucleated during
the surgical procedure. Figures F and G show the
microscopic features of the gross tumor in Figure F.
December 13, 2019