Abstract | PURPOSE: This study was performed to identify morphologic features of cardiac myxomas related to embolism and to provide a better understanding of the biology of these tumors, mainly in relation to their interleukin (IL)-6 expression and DNA content. PATIENTS AND METHODS: A total of 37 cardiac myxomas were reviewed retrospectively in a clinicopathologic study that included the correlation of echocardiographic and pathologic findings in 25 cases, together with immunohistochemical evaluation of IL-6 expression and flow cytometric DNA analysis of 35 tumors. RESULTS: There were 24 female patients and 13 male patients. The mean (+/- SD) age was 52 +/- 15 years. Fifty-four percent of patients presented with dyspnea, 51% presented with increased erythrocyte sedimentation rate (ESR), and 27% presented with embolic episodes, which were significantly associated with villous surface tumors. Atrial fibrillation was registered in 19% of patients and was significantly associated with large left atrial myxomas. Echocardiography proved to be a reliable method for preoperative diagnosis and for predicting tumor size and morphology. There was no perioperative mortality or long-term recurrences. The frequency of early surgical complications was associated with a longer mean ischemic time. Seventeen percent of tumors had abnormal DNA content, and 74% of tumors showed immunohistochemical expression of IL-6. Neither of these factors showed a significant association with embolism or constitutional illness. CONCLUSIONS: Villous surface myxomas are related to embolism, and large left atrial tumors are related to atrial fibrillation. Echocardiography is a reliable method with which to predict tumor size and morphology. Myxoma cells usually express IL-6, and some tumors have abnormal cellular DNA content. Surgical excision of the tumor is a safe and effective treatment.
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Authors | Elvira Acebo, J Fernando Val-Bernal, J Javier Gómez-Román, J Manuel Revuelta |
Journal | Chest
(Chest)
Vol. 123
Issue 5
Pg. 1379-85
(May 2003)
ISSN: 0012-3692 [Print] United States |
PMID | 12740251
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- DNA, Neoplasm
- Interleukin-6
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Topics |
- Adolescent
- Adult
- Aged
- Aneuploidy
- Child
- DNA, Neoplasm
(genetics)
- Echocardiography
- Female
- Flow Cytometry
- Heart Neoplasms
(genetics, metabolism, pathology, surgery)
- Humans
- Immunohistochemistry
- Interleukin-6
(metabolism)
- Male
- Middle Aged
- Myxoma
(genetics, metabolism, pathology, surgery)
- Neoplastic Cells, Circulating
- Retrospective Studies
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