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Invasive Development of Right Atrial Myxoma— A Case Report

Second Department of Internal Medicine, Kyushu University

Kiyoshi Matsumura

Second Department of Internal Medicine, Kyushu University

Isao Abe

Second Department of Internal Medicine, Kyushu University

Ryuichiro Kaku

Second Department of Internal Medicine, Kyushu University

Kazuo Kobayashi

Second Department of Internal Medicine, Kyushu University

Masatoshi Fujishima

Second Department of Internal Medicine, Kyushu University

Hidetoshi Aso

Department of Cardiovascular Surgery, Kyushu University

Koichi Tokunaga

Department of Cardiovascular Surgery, Kyushu University

Yutaka Ishii

First Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan

A thirty-nine-year-old man was admitted to the authors' department com plaining of exertional dyspnea and high fever. An echocardiogram showed a mass in the right atrium, which was observed to move to the right atrium during the systolic phase and to the right ventricle during the diastolic phase. Magnetic resonance imaging showed that the mass developed from the right atrium to the superior vena cava. Intravenous digital subtraction angiography also showed a partial defect of the right atrium as well as obstructions of both the superior vena cava and the bilateral innominate veins. A pulmonary hemodynamic scin tigram showed multiple defects at the mid and inferior areas of each lung, sug gesting multiple pulmonary infarctions. The right atrial tumor was surgically removed. The superior vena cava and the innominate veins were found to be obstructed by organized thrombi, and the tumor had invasively grown into the right atrial wall. Histologic findings demonstrated that most of the tumor was composed of organized thrombi with scattered myxomatous tissue and was di agnosed as cardiac myxoma. These histologic findings suggest that the histogen esis of this right atrial myxoma might be thrombogenic.

Angiology, Vol. 44, No. 9, 739-744 (1993)
DOI: 10.1177/000331979304400912


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