Multimodality Imaging of Right Atrial Masses
1
IMAGES IN CARDIOLOGY Multimodality Imaging of Right Atrial Masses Patricia Campbell, MD, Robert F. Padera, MD, PHD, Michael M. Givertz, MD Boston, Massachusetts Right atrial mass subcostal view → Right atrial masses → ↓ Right PA → ← Absent left PA Main Filling defect from right atrial mass → Right atrial mass Bioptome H&E Stain WT-1 Stain C D B A E C1 D Right atrial mass Bioptome From the Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. Manuscript received April 22, 2009, accepted April 29, 2009. A 76-year-old man presented with 2 months of dyspnea, early satiety, and lower extremity edema. Ten years previously, he underwent left extrapleural pneumonectomy for mesothe- lioma but had chest wall and mediastinal recurrences that required systemic chemotherapy and local radiation. Transthoracic echocardiography revealed right atrial dilation with a 4.9 6.4 cm mass attached to the anterior and inferior right atrial walls (A). Cardiac magnetic resonance imaging demonstrated 2 right atrial masses with gadolinium enhancement indicating vascularity: a 5.2 4.7 cm mass on the superior free wall, and a 4 4 cm mass partially obstructing inferior venal caval inflow on the lateral free wall (B). Right ventriculography (C) and echocardiographic- guided biopsy (pulmonary artery) (D) were performed (Online Videos 1, 2, 3 and 4). Histopathol- ogy confirmed the diagnosis of epithelioid-type mesothelioma (hematoxylin and eosin [H&E] stain, E, left; WT-1 stain positive for calretinin, E, right). The patient was not a candidate for surgical resection and died of progressive metastatic mesothelioma. Journal of the American College of Cardiology Vol. 55, No. 8, 2010 © 2010 by the American College of Cardiology Foundation ISSN 0735-1097/10/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.04.106
-
Upload
patricia-campbell -
Category
Documents
-
view
219 -
download
2
Transcript of Multimodality Imaging of Right Atrial Masses
FDWMMMAA
Journal of the American College of Cardiology Vol. 55, No. 8, 2010© 2010 by the American College of Cardiology Foundation ISSN 0735-1097/10/$36.00P
IMAGES IN CARDIOLOGY
Multimodality Imaging of Right Atrial MassesPatricia Campbell, MD, Robert F. Padera, MD, PHD, Michael M. Givertz, MD
Boston, Massachusetts
Right atrial masssubcostal view →
Right atrialmasses
→↓
Right PA →
← Absent left PA
Main
Filling defect fromright atrial mass →
Right atrial mass �
Bioptome �
H&E Stain WT-1 Stain
C D
BA
E
C1
D Right atrialmass
Bioptome
rom the Cardiovascularivision, Brigham andomen’s Hospital, Harvardedical School, Boston,assachusetts.anuscript receivedpril 22, 2009, acceptedpril 29, 2009.
A76-year-old man presented with 2 months of dyspnea, early satiety, and lower extremityedema. Ten years previously, he underwent left extrapleural pneumonectomy for mesothe-lioma but had chest wall and mediastinal recurrences that required systemic chemotherapy
and local radiation. Transthoracic echocardiography revealed right atrial dilation with a 4.9 � 6.4cm mass attached to the anterior and inferior right atrial walls (A). Cardiac magnetic resonanceimaging demonstrated 2 right atrial masses with gadolinium enhancement indicating vascularity: a5.2 � 4.7 cm mass on the superior free wall, and a 4 � 4 cm mass partially obstructing inferiorvenal caval inflow on the lateral free wall (B). Right ventriculography (C) and echocardiographic-guided biopsy (pulmonary artery) (D) were performed (Online Videos 1, 2, 3 and 4). Histopathol-ogy confirmed the diagnosis of epithelioid-type mesothelioma (hematoxylin and eosin [H&E] stain,E, left; WT-1 stain positive for calretinin, E, right). The patient was not a candidate for surgicalresection and died of progressive metastatic mesothelioma.
ublished by Elsevier Inc. doi:10.1016/j.jacc.2009.04.106
![Dysrhythmias (002) [Read-Only] - Aventri · Atrial AV node Ventricular Classification of Rhythm Abnormalities Supraventricular Atrial origin Atrial fibrillation Atrial flutter Atrial](https://static.fdocuments.net/doc/165x107/5f024baa7e708231d4038f22/dysrhythmias-002-read-only-aventri-atrial-av-node-ventricular-classification.jpg)
