A Giant Left Atrial Myxoma

Figure 1

(a) Computed tomographic scan revealing a large hypodense mass (+ 30 Hounsfield units) in the left atrium. (b) Transthoracic echocardiogram (apical 4-chamber view) showing a giant, solid, smooth mass in left atrium, attached to the interatrial septum causing severe obstruction of the mitral valve in diastole. (c) Intraoperative transesophageal echocardiogram confirming the attachment of the left atrial mass (7.17 × 4.63 cm) to the interatrial septum. (d) Resected tumor (7.7 × 5.5 × 3.7 cm) having a nodular hemorrhagic surface and mucoid glistening variegated cut surface with focal hemorrhage. (e) Microscopic examination (H&E stain) showing abundant myxoid stroma and scattered polygonal cells with scanty cytoplasm typical of myxoma. Myxoma cells forming rings, cords, and nests around the capillaries with positive immunoreactivity to calretinin.

(a)

(b)

(c)

(d)

(e)