Paroxysmal Nocturnal Dyspnea Secondary to Right Ventricular Myxoma: A Novel Presentation of an Unusual Tumor

Figure 1

Echocardiogram (a) shows an evident pedunculated mass, attached to the base of the anterior leaflet of the tricuspid valve and right ventricular septum extending into the right ventricular outflow tract. Gross pathology (b) shows a resected tumor, measuring 3.8 × 2.4 × 1.5 cm with infarction and degenerative changes. (c) H&E stain, 200x: stellate fibroblasts displaying small, elongated, dense nuclei and eosinophilic cytoplasm with indistinct cell borders enmeshed within a myxoid stroma. Extravasated red blood cells are seen adjacent to capillaries (arrows).