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Abstract
Purpose of Review Cardiac masses frequently present significant diagnostic and therapeutic clinical challenges and encompass a broad set of lesions that can be either neoplastic or non-neoplastic. We sought to provide an overview of cardiac tumors using a cardiac chamber prevalence approach and providing epidemiology, imaging, histopathology, diagnostic workup, treatment, and prognoses of cardiac tumors. Recent Findings Cardiac tumors are rare but remain an important component of cardio-oncology practice. Over the past decade, the advances in imaging techniques have enabled a noninvasive diagnosis in many cases. Indeed, imaging modalities such as cardiac magnetic resonance, computed tomography, and positron emission tomography are important tools for diagnosing and characterizing the lesions. Although an epidemiological and multimodality imaging approach is useful, the definite diagnosis requires histologic examination in challenging scenarios, and histopathological characterization remains the diagnostic gold standard. Summary A comprehensive clinical and multimodality imaging evaluation of cardiac tumors is fundamental to obtain a proper differential diagnosis, but histopathology is necessary to reach the final diagnosis and subsequent clinical management.
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Gravina M, Casavecchia G, Manuppelli V, Totaro A, Macarini L, Di Biase M, Brunetti ND. Mitral annular calcification: Can CMR be useful in identifying caseous necrosis? Interv Med Appl Sci 2020; 11:71-73. [PMID: 32148907 PMCID: PMC7044563 DOI: 10.1556/1646.10.2018.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Mitral annular calcification (MAC) can resemble an intracardiac mass and it is defined as a chronic degeneration of the mitral annulus. Often reported is caseous mitral annulus calcification (CMAC), a periannular, extensive calcification resembling a tumor. We report the case of a 68-year-old woman who had been hospitalized for palpitations and dyspnea. The transthoracic and transesophageal echocardiography revealed a non-homogeneous, slightly mobile, round mass, attached to the ventricular side of posterior mitral leaflet, with central echo-lucent area and without acoustic shadowing. Therefore, a cardiac magnetic resonance (CMR) was performed; delayed enhancement sequences showed a non-enhanced central core surrounded by a hyperenhanced rim (fibrous cap). To confirm the diagnosis, a multidetector computed tomography (MDCT) was performed; the MDCT showed a hyperdense mass with a hypodense center and a calcified peripheral rim. The central content had heterogeneous fluid density without significant contrast enhancement. The MDCT findings were considered highly suggestive of CMAC. CMR may be useful for the identification and definition of pericardial and myocardial masses and CMAC.
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Affiliation(s)
- Matteo Gravina
- Department of Radiology, University of Foggia, Foggia, Italy
| | | | | | - Antonio Totaro
- Department of Cardiology, University of Foggia, Foggia, Italy
| | - Luca Macarini
- Department of Radiology, University of Foggia, Foggia, Italy
| | - Matteo Di Biase
- Department of Cardiology, University of Foggia, Foggia, Italy
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Fibrolipoma of the left ventricle: an uncommon incidental autopsy finding. Forensic Sci Med Pathol 2019; 16:362-365. [PMID: 31776801 DOI: 10.1007/s12024-019-00197-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2019] [Indexed: 10/25/2022]
Abstract
Fibrolipoma of the heart is an unusual benign tumorous entity encountered, if present, during an ordinary imaging workout or at autopsy. It is often clinically silent but it can also be symptomatic depending on the size and location of the tumor. We report a case of an 82-year-old man with a medical history of malignant pleural mesothelioma. The decedent was referred to our department to undergo a forensic autopsy after a fall. Postmortem examination revealed a large encapsulated gelatinous, yellowish cardiac mass with its pedicle on the subendocardial region of the left ventricular anterior wall and interventricular septum, protruding into the left ventricular cavity. Histological examination confirmed the diagnosis of cardiac fibro-lipoma, a rare histologic variant of lipoma, irrelevant to the cause of death in the present case. The rarity of the occurrence of fibro-lipomas provides clinical implications for the inclusion of the entity in the differential diagnosis of a cardiac mass.
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Lee DC, Markl M, Dall’Armellina E, Han Y, Kozerke S, Kuehne T, Nielles-Vallespin S, Messroghli D, Patel A, Schaeffter T, Simonetti O, Valente AM, Weinsaft JW, Wright G, Zimmerman S, Schulz-Menger J. The growth and evolution of cardiovascular magnetic resonance: a 20-year history of the Society for Cardiovascular Magnetic Resonance (SCMR) annual scientific sessions. J Cardiovasc Magn Reson 2018; 20:8. [PMID: 29386064 PMCID: PMC5791345 DOI: 10.1186/s12968-018-0429-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 01/17/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND AND PURPOSE The purpose of this work is to summarize cardiovascular magnetic resonance (CMR) research trends and highlights presented at the annual Society for Cardiovascular Magnetic Resonance (SCMR) scientific sessions over the past 20 years. METHODS Scientific programs from all SCMR Annual Scientific Sessions from 1998 to 2017 were obtained. SCMR Headquarters also provided data for the number and the country of origin of attendees and the number of accepted abstracts according to type. Data analysis included text analysis (key word extraction) and visualization by 'word clouds' representing the most frequently used words in session titles for 5-year intervals. In addition, session titles were sorted into 17 major subject categories to further evaluate research and clinical CMR trends over time. RESULTS Analysis of SCMR annual scientific sessions locations, attendance, and number of accepted abstracts demonstrated substantial growth of CMR research and clinical applications. As an international field of study, significant growth of CMR was documented by a strong increase in SCMR scientific session attendance (> 500%, 270 to 1406 from 1998 to 2017, number of accepted abstracts (> 700%, 98 to 701 from 1998 to 2018) and number of international participants (42-415% increase for participants from Asia, Central and South America, Middle East and Africa in 2004-2017). 'Word clouds' based evaluation of research trends illustrated a shift from early focus on 'MRI technique feasibility' to new established techniques (e.g. late gadolinium enhancement) and their clinical applications and translation (key words 'patient', 'disease') and more recently novel techniques and quantitative CMR imaging (key words 'mapping', 'T1', 'flow', 'function'). Nearly every topic category demonstrated an increase in the number of sessions over the 20-year period with 'Clinical Practice' leading all categories. Our analysis identified three growth areas 'Congenital', 'Clinical Practice', and 'Structure/function/flow'. CONCLUSION The analysis of the SCMR historical archives demonstrates a healthy and internationally active field of study which continues to undergo substantial growth and expansion into new and emerging CMR topics and clinical application areas.
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Affiliation(s)
- Daniel C. Lee
- Division of Cardiology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL USA
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N. Michigan Avenue Suite 1600, Chicago, IL 60611 USA
| | - Michael Markl
- Department of Radiology, Feinberg School of Medicine, Northwestern University, 737 N. Michigan Avenue Suite 1600, Chicago, IL 60611 USA
- Department of Biomedical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL USA
| | - Erica Dall’Armellina
- Division of Biomedical Imaging, Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - Yuchi Han
- Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| | | | - Titus Kuehne
- Charité – Medical University Berlin and German Heart Institute Berlin, Berlin, Germany
| | | | - Daniel Messroghli
- Charité – Medical University Berlin and German Heart Institute Berlin, Berlin, Germany
| | | | - Tobias Schaeffter
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
- Kings College London, London, UK
| | | | | | | | | | | | - Jeanette Schulz-Menger
- Department of Cardiology and Nephrology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and HELIOS Klinikum Berlin Buch, Berlin, Germany
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Fatty Images of the Heart: Spectrum of Normal and Pathological Findings by Computed Tomography and Cardiac Magnetic Resonance Imaging. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5610347. [PMID: 29503824 PMCID: PMC5818975 DOI: 10.1155/2018/5610347] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/05/2017] [Indexed: 01/07/2023]
Abstract
Ectopic cardiac fatty images are not rarely detected incidentally by computed tomography and cardiac magnetic resonance, or by exams focused on the heart as in general thoracic imaging evaluations. A correct interpretation of these findings is essential in order to recognize their normal or pathological meaning, focusing on the eventually associated clinical implications. The development of techniques such as computed tomography and cardiac magnetic resonance allowed a detailed detection and evaluation of adipose tissue within the heart. This pictorial review illustrates the most common characteristics of cardiac fatty images by computed tomography and cardiac magnetic resonance, in a spectrum of normal and pathological conditions ranging from physiological adipose images to diseases presenting with cardiac fatty foci. Physiologic intramyocardial adipose tissue may normally be present in healthy adults, being not related to cardiac affections and without any clinical consequence. However cardiac fatty images may also be the expression of various diseases, comprehending arrhythmogenic right ventricular dysplasia, postmyocardial infarction lipomatous metaplasia, dilated cardiomyopathy, and lipomatous hypertrophy of the interatrial septum. Fatty neoplasms of the heart as lipoma and liposarcoma are also described.
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Colunga Blanco S, Martín Fernández M, Corros Vicente C, Álvarez Cabo R, Astudillo González MA. A mass in the right atrium: A diagnostic dilemma. CIRUGIA CARDIOVASCULAR 2017. [DOI: 10.1016/j.circv.2016.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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7
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Abstract
Cardiac tumours are a rare, but often devastating, clinical diagnosis. They encompass a broad set of lesions that include both neoplastic and non-neoplastic conditions. Cardiac tumours are often diagnosed incidentally during work-up for other conditions, or during ultrasound, CT, or MRI scans for unusual or nonspecific symptoms. In the past decade, important changes have been made in the nomenclature and the recommendations for diagnosis of cardiac tumours, as highlighted by the WHO's 2015 revision of the classification of cardiac tumours. Moreover, important advances in molecular genetics and therapeutics offer new approaches for the diagnosis and treatment of affected patients. In this Review, we provide an overview of the clinical, pathological, and imaging characteristics of all types of cardiac masses, including both benign and malignant primary cardiac neoplasms.
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Bianchi G, Cerillo AG, Murzi M, Solinas M. Surgical resection of colorectal carcinomas metastatic to the heart. J Card Surg 2016; 31:677-682. [PMID: 27601061 DOI: 10.1111/jocs.12841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Colorectal carcinomas metastatic to the heart are rare. We present a case of colonic carcinoma metastatic to the right atrium and discuss the management and prognosis of these rare lesions.
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Affiliation(s)
- Giacomo Bianchi
- Department of Adult Cardiac Surgery, Ospedale del Cuore, Fondazione Toscana "G. Monasterio,", Massa, Italy.
| | - Alfredo Giuseppe Cerillo
- Department of Adult Cardiac Surgery, Ospedale del Cuore, Fondazione Toscana "G. Monasterio,", Massa, Italy
| | - Michele Murzi
- Department of Adult Cardiac Surgery, Ospedale del Cuore, Fondazione Toscana "G. Monasterio,", Massa, Italy
| | - Marco Solinas
- Department of Adult Cardiac Surgery, Ospedale del Cuore, Fondazione Toscana "G. Monasterio,", Massa, Italy
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9
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Belov IV, Nechaenko MA, Kuznetsova LM, Khovrin VV, Fedorov DN, Kiprenskiĭ AI, Dombrovskaia AV. [Solid lesions of heart valves]. Khirurgiia (Mosk) 2016:11-18. [PMID: 26977862 DOI: 10.17116/hirurgia2016211-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To analyze clinical-diagnostic and surgical aspects of cardiac valve solid lesions as well as long-term results of surgical treatment. MATERIAL AND METHODS Clinical, diagnostic and surgical aspects of treatment of 51 patients with tumorous and pseudotumorous lesions of cardiac valves were analyzed. RESULTS AND DISCUSSION Hospital complications were observed in 17.7% of patients. Mortality rate was 3.9%. 1- and 28-year overall survival was 100% and 94.1% respectively. Quality of life was good, satisfactory and unsatisfactory in 73.5%, 20.4% and 6.1% of cases respectively. CONCLUSION Timely diagnostics of tumorous and pseudotumorous lesions of cardiac valves is very difficult but possible based on short history, positional dependence of symptoms, embolic events without rhythm disturbances. Additional instrumental methods including TTE, TEE, CT and MRI are necessary to define diagnosis. Intraoperative diagnostics and immediate histological survey are useful to determine volume of surgery in each case. Successful surgical treatment implies urgency, hypothermic perfusion and pharmaco-cold cardioplegia during operation.
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Affiliation(s)
- Iu V Belov
- B.V. Petrovsky Russian Research Center of Surgery, Moscow
| | - M A Nechaenko
- B.V. Petrovsky Russian Research Center of Surgery, Moscow
| | - L M Kuznetsova
- B.V. Petrovsky Russian Research Center of Surgery, Moscow
| | - V V Khovrin
- B.V. Petrovsky Russian Research Center of Surgery, Moscow
| | - D N Fedorov
- B.V. Petrovsky Russian Research Center of Surgery, Moscow
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Wang H, Hu J, Sun X, Wang P, Du Z. An asymptomatic right atrial intramyocardial lipoma: a management dilemma. World J Surg Oncol 2015; 13:20. [PMID: 25885214 PMCID: PMC4332731 DOI: 10.1186/s12957-015-0441-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 01/07/2015] [Indexed: 12/28/2022] Open
Abstract
Background The atrial intramyocardial lipomas are rare benign unusual tumors of the heart. The indication and best form of treatment for cardiac lipomas remain controversial. Case presentation The atrial intramyocardial lipomas are rare benign unusual tumors of the heart. We report a 55-year-old Chinese female with a history of hypertension. Echocardiography and 64-slice computed tomography showed a fatty mass in the right atrium. Although she was asymptomatic, a surgical resection was indicated since the lipoma could cause an embolism and arrhythmias and its potential to enlarge. Surgery revealed an intramyocardial lipoma on the atrial free wall which was confirmed by histopathology. The patient remained asymptomatic after surgery, and no recurrence was seen after 1 year. Conclusions Although cardiac lipomas are usually benign, tumor embolism, potential to enlarge, or intracardiac obstruction can cause a critical situation. Therefore, a surgical resection was indicated even in asymptomatic patients. Electronic supplementary material The online version of this article (doi:10.1186/s12957-015-0441-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Haiyong Wang
- Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
| | - Jiangwei Hu
- Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
| | - Xiaolin Sun
- Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
| | - Pingshan Wang
- Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
| | - Zhenzong Du
- Department of Cardiothoracic Surgery, Affiliated Hospital of Guilin Medical University, Guilin, 541001, China.
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11
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Yoon YE, Hong YJ, Kim HK, Kim JA, Na JO, Yang DH, Kim YJ, Choi EY. 2014 korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: a joint report of the korean society of cardiology and the korean society of radiology. Korean Circ J 2014; 44:359-85. [PMID: 25469139 PMCID: PMC4248609 DOI: 10.4070/kcj.2014.44.6.359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/17/2014] [Accepted: 10/19/2014] [Indexed: 12/19/2022] Open
Abstract
Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.
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Affiliation(s)
- Yeonyee E Yoon
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yoo Jin Hong
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung-Kwan Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jeong A Kim
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jin Oh Na
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Dong Hyun Yang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Young Jin Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eui-Young Choi
- Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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12
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Yoon YE, Hong YJ, Kim HK, Kim JA, Na JO, Yang DH, Kim YJ, Choi EY, The Korean Society of Cardiology and the Korean Society of Radiology. 2014 Korean guidelines for appropriate utilization of cardiovascular magnetic resonance imaging: a joint report of the Korean Society of Cardiology and the Korean Society of Radiology. Korean J Radiol 2014; 15:659-88. [PMID: 25469078 PMCID: PMC4248622 DOI: 10.3348/kjr.2014.15.6.659] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 09/25/2014] [Indexed: 12/18/2022] Open
Abstract
Cardiac magnetic resonance (CMR) imaging is now widely used in several fields of cardiovascular disease assessment due to recent technical developments. CMR can give physicians information that cannot be found with other imaging modalities. However, there is no guideline which is suitable for Korean people for the use of CMR. Therefore, we have prepared a Korean guideline for the appropriate utilization of CMR to guide Korean physicians, imaging specialists, medical associates and patients to improve the overall medical system performances. By addressing CMR usage and creating these guidelines we hope to contribute towards the promotion of public health. This guideline is a joint report of the Korean Society of Cardiology and the Korean Society of Radiology.
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Affiliation(s)
- Yeonyee E Yoon
- Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam 463-707, Korea
| | - Yoo Jin Hong
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Hyung-Kwan Kim
- Division of Cardiology, Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul National University Hospital, Seoul 110-744, Korea
| | - Jeong A Kim
- Department of Radiology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang 411-706, Korea
| | - Jin Oh Na
- Cardiovascular Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea
| | - Dong Hyun Yang
- Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea
| | - Young Jin Kim
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 120-752, Korea
| | - Eui-Young Choi
- Division of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 135-720, Korea
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Rathod KS, Westwood M, Uppal R, Deaner A. An incidental finding of a calcified right-atrial mass in a young patient treated with chemotherapy 20 years ago. BMJ Case Rep 2014; 2014:bcr-2014-203564. [PMID: 24827924 DOI: 10.1136/bcr-2014-203564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We describe a case of a young woman presenting with lethargy and pleuritic chest pain. She had a medical history of leukaemia treated successfully 20 years ago with chemotherapy via a long line. Although initial investigations suggested a diagnosis of pulmonary embolism (PE; on CT pulmonary angiogram (CTPA)) and a possible thrombus in the right atrium, her symptoms appeared out of proportion in relation to this diagnosis. Further imaging using transthoracic echocardiography suggested the presence of a calcified mass in the right atrium. She underwent successful surgical resection of the mass which was found to be attached to the lateral wall of the right atrium. She made an uneventful recovery and continued on warfarin therapy for 6 months in view of the diagnosis of PE on CTPA. We believe the calcified mass was probably caused by the presence of a long line at the time of her chemotherapy.
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Affiliation(s)
| | - Mark Westwood
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - Rakesh Uppal
- Department of Cardiology, Barts Health NHS Trust, London, UK
| | - Andrew Deaner
- Department of Cardiology, BHRUT, Ilford, UK Department of Cardiology, Barts Health NHS Trust, London, UK
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Abstract
A case of a 70-year-old female with a history of hypertension, atrial fibrillation, pacer implantation for symptomatic bradycardia, and a prior cerebrovascular accident, and had developed persistent methicillin-sensitive Staphylococcus aureus bacteremia is reported here. As part of her evaluation, a transesophageal echocardiogram was performed, and even though no vegetations were seen on either pacer wires or cardiac valves, a massive homogeneous thickening of the superior portion of the interatrial septum extending to the posterior and roof portions of the right atrial wall as well as to the superior vena cava causing proximal compression of this vessel was noted. Computed tomographic examination of the chest helped to determine that this mass density was not a tumor but in fact intrapericardial fat. Imaging findings and existing literature on this topic are reviewed.
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Affiliation(s)
- Angel López-Candales
- Division of Cardiovascular Diseases, University of Cincinnati School of Medicine, Cincinnati, OH, USA
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15
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Motwani M, Kidambi A, Herzog BA, Uddin A, Greenwood JP, Plein S. MR imaging of cardiac tumors and masses: a review of methods and clinical applications. Radiology 2013; 268:26-43. [PMID: 23793590 DOI: 10.1148/radiol.13121239] [Citation(s) in RCA: 239] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cardiac masses are usually first detected at echocardiography. In their further evaluation, cardiac magnetic resonance (MR) imaging has become a highly valuable technique. MR imaging offers incremental value owing to its larger field of view, superior tissue contrast, versatility in image planes, and unique ability to enable discrimination of different tissue characteristics, such as water and fat content, which give rise to particular signal patterns with T1- and T2-weighted techniques. With contrast material-enhanced MR imaging, additional tissue properties such as vascularity and fibrosis can be demonstrated. MR imaging can therefore contribute to the diagnosis of a cardiac mass as well as be used to detail its relationship to other cardiac and extracardiac structures. These assessments are important to plan therapy, such as surgical intervention. In addition, serial MR studies can be used to monitor tumor regression after surgery or chemotherapy. Primary cardiac tumors are very rare; metastases and pseudotumors (eg, thrombus) are much more common. This article provides an overview of cardiac masses and reviews the optimal MR imaging techniques for their assessment.
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Affiliation(s)
- Manish Motwani
- Multidisciplinary Cardiovascular Research Centre and Leeds Institute of Genetics, Health and Therapeutics, University of Leeds, Leeds LS2 9JT, England
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Goldfarb JW, Arnold-Anteraper S. Water-fat separation imaging of the heart with standard magnetic resonance bSSFP CINE imaging. Magn Reson Med 2013; 71:2096-104. [PMID: 23904254 DOI: 10.1002/mrm.24879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/18/2013] [Accepted: 06/18/2013] [Indexed: 12/19/2022]
Abstract
PURPOSE To study balanced steady-state free precession CINE phase-sensitive water-fat separation imaging in four cardiac imaging planes to determine the necessary phase correction and image artifacts particular to this technique. METHODS Ten healthy volunteers and two subjects with known heart pathologies were studied with standard balanced steady-state free precession CINE imaging. Water-only and fat-only images were calculated using sign detection of the real part of the complex image after phase correction with constant and linear terms. Phase correction values were determined using both manual and automated methods. Differences in phase correction values between imaging planes, cardiac phases, coil elements, automated image reconstruction parameters as well as artifact scores between the automated and manual methods were studied with statistical tests. RESULTS Water-fat separation performed well in the heart after constant and linear phase correction. Both constant (p = 0.8) and linear x (p = 1) and y (p = 1) phase correction values did not vary significantly across cardiac phases, but varied significantly among the coils (p < 0.001) and imaging planes (p < 0.001). False water-fat separation artifacts were most frequent in the chest/back and also were present at the mitral and aortic valves. CONCLUSION Constant and linear phase correction is necessary to provide consistent results in standard imaging planes using a balanced steady-state free precession water-fat separation postprocessing algorithm applied to standard cardiac CINE imaging.
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Affiliation(s)
- James W Goldfarb
- Department of Research and Education, Saint Francis Hospital, Roslyn, New York, USA; Program in Biomedical Engineering, SUNY Stony Brook, Stony Brook, New York, USA
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Yinon Y, Chitayat D, Blaser S, Seed M, Amsalem H, Yoo SJ, Jaeggi ET. Fetal cardiac tumors: a single-center experience of 40 cases. Prenat Diagn 2010; 30:941-9. [DOI: 10.1002/pd.2590] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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18
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Fazio G, Grassedonio E, Lo Re G, Maurizio M, Sutera L, Bacarella D, Novo G, Pipitone S, Novo S, Midiri M. A cardiac fibroma in a 7-year-old asymptomatic girl admitted for ECG anomalies. J Cardiovasc Med (Hagerstown) 2010; 13:406-9. [PMID: 20592623 DOI: 10.2459/jcm.0b013e328339d834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Dickerson JA, Smith M, Kalbfleisch S, Firstenberg MS. Lipomatous Hypertrophy of the Intraatrial Septum Resulting in Right Atrial Inflow Obstruction and Atrial Flutter. Ann Thorac Surg 2010; 89:1647-9. [DOI: 10.1016/j.athoracsur.2009.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 09/30/2009] [Accepted: 10/01/2009] [Indexed: 11/29/2022]
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20
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Affiliation(s)
- Dudley J. Pennell
- From the Cardiovascular MR Unit, Royal Brompton Hospital, London, UK and Imperial College, London, UK
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21
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Gupta S, Plein S, Greenwood JP. The Coumadin Ridge: An Important Example of a Left Atrial Pseudotumour demonstrated by Cardiovascular Magnetic Resonance Imaging. J Radiol Case Rep 2009; 3:1-5. [PMID: 22470681 DOI: 10.3941/jrcr.v3i9.210] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A coumadin ridge is an occasionally observed, but seldom described structure seen in the left atrium during cardiac magnetic resonance (CMR) imaging. In this case, the coumadin ridge was particularly prominent and could easily have been mistaken for a tumour or thrombus. Using the combined assessment from different CMR pulse sequences, we were able to correctly identify it as the coumadin ridge. We make the reader aware of the location and the CMR imaging features of this structure so that misdiagnosis may be avoided.
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Affiliation(s)
- Sanjay Gupta
- Academic Unit of Cardiovascular Medicine, Leeds General Infirmary, Leeds, UK
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Fazio G, Grassedonio E, Cracolici E, Novo G, Sutera L, Pipitone S, Mongiovi M, Novo S, Midiri M. Cardiovascular magnetic resonance characterization of a hamartoma in an asyntomatic child. Int J Cardiol 2009; 132:e102-4. [DOI: 10.1016/j.ijcard.2007.08.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2007] [Accepted: 08/11/2007] [Indexed: 11/24/2022]
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Rajani R, Bhanot DK, Prasad SK, Holt PM. Mitral valve myxoma: a case of mistaken identity. J Cardiovasc Med (Hagerstown) 2009; 9:1290-2. [PMID: 19001944 DOI: 10.2459/jcm.0b013e3283168d65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A case of a rare mitral valve myxoma is reported in a 61-year-old gentleman who presented with recurrent embolic events. The mass was initially diagnosed as thrombus on cardiac MRI, but was later confirmed to be myxomatous in origin, at surgery, and histological examination.
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Affiliation(s)
- Ronak Rajani
- aDepartment of Cardiology, Maidstone Hospital, Hermitage Lane, Maidstone, Kent, UK bCardiovascular Magnetic Resonance Unit, Royal Brompton Hospital, Sydney Street, London, UK
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Monti L, Renifilo E, Profili M, Balzarini L. Cardiovascular magnetic resonance features of caseous calcification of the mitral annulus. J Cardiovasc Magn Reson 2008; 10:25. [PMID: 18501023 PMCID: PMC2435111 DOI: 10.1186/1532-429x-10-25] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2008] [Accepted: 05/26/2008] [Indexed: 11/10/2022] Open
Abstract
We present two cases of caseous calcification of the mitral annulus studied by Cardiovascular Magnetic Resonance; the diagnostic feature of this rare cardiac mass are described.
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Affiliation(s)
- Lorenzo Monti
- Department of Radiology, I.R.C.C.S. Istituto Clinico Humanitas, Rozzano, Milan, Italy
- Department of Cardiology, I.R.C.C.S. Istituto Clinico Humanitas, Rozzano, Milan, Italy
- Cardiovascular Magnetic Resonance, I.R.C.C.S. Istituto Clinico Humanitas, Via Manzoni 56, 20089 Rozzano (MI), Italy
| | - Eva Renifilo
- Department of Radiology, I.R.C.C.S. Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - Manuel Profili
- Department of Radiology, I.R.C.C.S. Istituto Clinico Humanitas, Rozzano, Milan, Italy
| | - Luca Balzarini
- Department of Radiology, I.R.C.C.S. Istituto Clinico Humanitas, Rozzano, Milan, Italy
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Hoppe UC. Herzerkrankungen bei Tumoren und Tumortherapie. Internist (Berl) 2007; 48:268-75. [PMID: 17287966 DOI: 10.1007/s00108-006-1779-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cardiac disease may occur as a direct complication of heart tumors or as an indirect complication of malignancies due to antineoplastic therapy. While primary cardiac neoplasias are rare, metastases to various cardiac structures are common. The cardiotoxicity of anticancer agents can lead to significant complications that may affect patients being treated for various non-cardiac neoplasias. The severity of such cardiovascular damage depends on many factors, such as the site of molecular action, the immediate and cumulative dose, the method of administration, and the presence of any underlying cardiac condition. Moreover, toxicity can be affected by concomitant radiation. Cardiotoxic effects can occur during the administration of the drug, but they may not manifest themselves until months or years after the patient has been treated. Since cardiovascular disease and cancer are both common, precise knowledge of therapeutic interactions and complications is necessary.
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Affiliation(s)
- U C Hoppe
- Klinik III für Innere Medizin, Universität zu Köln, Kerpener Strasse 62, 50937 Köln, Deutschland.
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