1/24. Malignant mesothelioma of the pericardium: case reports and immunohistochemical studies including Ki-67 expression.Pericardial malignant mesothelioma (PMM) is extremely rare compared with pleural cases of mesothelioma. We present the clinical and pathological features of three autopsy cases with PMM. All three cases showed rapid progress and died of heart failure. Detailed examination was obtained from the autopsy. Macroscopic appearances of each case showed a thickened pericardium due to tumor invasion. Microscopic observations of all cases led to a diagnosis of epithelial-type malignant mesothelioma (MM). The results of immunohistochemical examinations were similar to the previous published work on pleural mesothelioma. To disclose the pathological characteristics of PMM, we analyzed Ki-67 labeling index (LI) of three cases of PMM and five cases of pleural MM that died within 2 years. The difference of Ki-67 LI between PMM and pleural MM was not significant (P > 0.05). The poor prognosis of patients with PMM must be caused by restricted cardiac wall motion due to tumor involvement, in addition to the tumor proliferation itself.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/24. Echocardiographic manifestations of aortic cusp rupture in a myxomatous aortic valve.A 16-year-old pregnant black girl who had spontaneous perforation of the aortic valve associated with myxomatous aortic valvular degeneration is presented. The echocardiogram revealed chaotic systolic motion of one of the aortic cusps, diastolic aortic valvular fluttering, and abnormal diastolic echoes in the left ventricular outflow tract. The report illustrates that the echocardiographic features associated with valvular vegetations are not specific for infectious endocarditis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
3/24. Multiple cardiac papillary fibroelastoma and transient left ventricular apical ballooning syndrome in an elderly woman: case report.An elderly Japanese woman presented with evidence of a myocardial infarction. Emergency angiography showed no significant atherosclerotic disease, but the anterior and anteroseptal walls were akinetic, with 'ballooning' of the apex. She was suspected to have transient left ventricular apical ballooning syndrome (TLVABS). Two months later, transthoracic echocardiography showed normal left ventricular wall motion and function, together with a 5-mm cardiac papillary fibroelastoma (CPF) attached to the aortic valve. Transesophageal echocardiography showed a stalked CPF on the aortic side of the left coronary cusp, and a smaller CPF on the right coronary cusp. It was hypothesized that the CPF caused the TLVABS through myocardial stunning. This may occur as a result of transient dynamic ostial occlusion by the fibroelastoma, or because of emboli from the fibroelastoma which then subsequently spontaneously lysed. This syndrome may represent an unusual manifestation of transient cardiac ischemia. Whilst TLVABS has been mainly reported in Japanese patients, more recent studies have suggested that other populations might also be affected.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/24. Intracardiac rhabdomyosarcoma: transesophageal echocardiographic findings and diagnosis.Transesophageal echocardiography (TEE) was performed on a 41-year-old woman who presented with a cerebrovascular accident. TEE confirmed the presence of a morphologically bizarre biatrial tumor with precarious, vigorous motion throughout the cardiac cycle. Surgical intervention was decided on, and the patient underwent cardiac surgery for tumor excision 16 hours after TEE. Intraoperative frozen section diagnosis was spindle cell sarcoma, and subsequent immunohistochemical analysis showed the tumor to be a rhabdomyosarcoma. The data are presented here, and the role of TEE to establish a preoperative diagnosis of intracardiac tumor is discussed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/24. Massive posterior mitral annular calcification causing dynamic left ventricular outflow tract obstruction: mechanism and management implications.We report a case of massive posterior mitral annular calcification causing severe systolic anterior motion of the anterior mitral leaflet and dynamic left ventricular outflow tract obstruction. Mechanism of genesis of systolic anterior motion by this unusual mechanism is illustrated. Importance of recognizing this mechanism and its implications for surgical therapy are discussed. Our patient also had liquefaction necrosis of mitral annular calcification causing its extension into left ventricular myocardium mimicking a tumor.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
6/24. Severe left ventricular dysfunction in left atrial myxoma--report of 2 cases.We report 2 patients with left atrial (LA) myxoma with associated severe left ventricular (LV) dysfunction. Both presented with progressive effort intolerance without a history suggestive of acute coronary event. LA myxoma was diagnosed by transthoracic echocardiography, which also detected severe systolic dysfunction and LV dilatation. Regional wall motion abnormality and thinning were absent. Coronary angiograms also showed no occlusive disease, but distal ectasia was seen in 1 patient. Metabolic and endocrine causes of reversible LV dysfunction were excluded. Cardiac function improved following surgery for myxoma in 1 patient. LV dysfunction, thus far, has not been directly attributed to myxoma. Coronary embolization leading to myocardial infarction and coexisting coronary atherosclerosis are the recognized methods by which LV dysfunction manifests in myxoma. Our report suggests the possibility of reversible severe global LV dysfunction due to cardiodepressant effect of myxoma through as yet unclear mechanisms.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/24. Unusual appearance of mitral annular calcification mimicking intracardiac tumor prompting early surgery.Although mitral annular calcification (MAC) is usually easy to diagnose by transthoracic echocardiography, we experienced a rare case with MAC which looked like an intracardiac tumor. The patient who had been on chronic hemodialysis for 20 years was admitted to our hospital because of dyspnea. Transthoracic echocardiography showed a mass with severe calcification on the anterior mitral annulus and mean mitral gradient of 20 mm Hg. Because of the suspicion of the intracardiac calcified tumor that restricted mitral valve motion causing mitral obstruction, she underwent resection of the mass and mitral valve replacement. Pathological findings showed that the mass had a calcified envelope containing liquefied necrotic eosinophilic material with lympocytic infiltrate inside consistent with MAC. We should consider a possibility of MAC when we see a severe calcified mass attached to the mitral annulus in a patient on long-term hemodialysis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/24. A case report of a round cystic tumor in the left ventricular outflow tract.We report a case of a patient who was admitted to our hospital complaining of angina pectoris. On auscultation, a systolic ejection murmur was heard at the right upper sternal border. Transthoracic echocardiography displayed regional wall motion abnormalities and detected a mobile mass in the left ventricular outflow tract, causing mild obstruction during systole. The mass appeared as an unilocular cystic tumor. coronary angiography showed a significant lesion in the left anterior descending artery. Surgical treatment was indicated for coronary artery disease and for the unpredictable behaviour of the neoplasm. The mass was identified as arising from the top of the anterior papillary muscle. Histopathological examination revealed that the tumor was a cavernous hemangioma. Cardiac hemangiomas are rare, benign vascular tumors of the heart. This is an unusual case of left ventricular hemangioma incidentally discovered, which raised an interesting differential diagnosis.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/24. Abnormal left ventricular catheter motion: an ancillary angiographic sign of left atrial myxoma.The normal motion of a left ventricular catheter parallels that of the aortic root; it moves anterior during systole and posterior during diastole. In contrast, a prolapsing left atrial myxoma causes paradoxical motion of the catheter; posterior during systole and anterior during diastole. Paradoxical motion was found in each of five cases of prolapsing left atrial myxoma (no false negatives), and in six out of 61 controls (six false positives). In the false positive cases, the catheter was not positioned on the ventricular floor and usually only minor degrees of abnormal motion were present. Paradoxical motion of the left ventricular catheter is an ancillary angiographic finding in prolapsing left atrial tumor.- - - - - - - - - - ranking = 9keywords = motion (Clic here for more details about this article) |
10/24. Echocardiographic pattern of right atrial tumour motion.Propagation of Wilm's tumour to the right atrium was diagnosed by echocardiography. The tumour prolapsed into the right ventricle during each atrial systole. The presence of the tumour and its motion were confirmed by cardiac catheterization, cineangiography, and surgical exploration. Successful resection of the tumour was accomplished. echocardiography was helpful in detecting the presence of the right atrial tumour and accurately reflected the pattern of its atrioventricular motion.- - - - - - - - - - ranking = 6keywords = motion (Clic here for more details about this article) |
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