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(Circulation. 1995;92:274-275.)
© 1995 American Heart Association, Inc.

Articles

Primary Cardiac Neurilemoma

Mayuko Kodama, MD; Makoto Aoki, MD; Kikuo Sakai, MD

From the Department of Cardiology, National Hospital Kyushu Medical Center, Fukuoka, Japan.

Correspondence to Kikuo Sakai, MD, Department of Cardiology, National Hospital Kyushu Medical Center, 1-8-1, Jigyouhama, Chuo-ku, Fukuoka, Japan 810.

Key Words: cardiovascular images • pericardium • tumors

	Introduction

Top Introduction

 
A 50-year-old woman was admitted to our hospital for a close examination of a pericardial effusion. Five months before admission, she began experiencing episodes of exertional dyspnea and orthopnea. At the hospital she attended at that time, she was diagnosed as having a large pericardial effusion and was treated with pericardial drainage.

On admission to our hospital, her chest x-ray films showed marked cardiac enlargement. An echocardiographic examination and cardiac magnetic resonance imaging (Fig 1) revealed an ovoid right atrial mass and a moderate pericardial effusion. Under cardiopulmonary bypass, the right atrial mass, measuring 9.0x5.0x6.0 cm (Fig 2A), was successfully removed. The tumor surface was smooth, and its cut surface was yellow (Fig 2B). Microscopic sections showed the typical Antoni type A tissue (Fig 3A) and Antoni type B tissue (Fig 3B). The tumor was interpreted as a cardiac neurilemoma. Primary cardiac tumor is very rare; to the best of our knowledge, only four cases have been reported in the literature.

View larger version (116K): [in this window] [in a new window]   Figure 1. Magnetic resonance images of the chest showing an ovoid right atrial tumor and a mild pericardial effusion. A, T1W image. B, T2W image. RA indicates right atrium; RV, right ventricle; and LV, left ventricle.

View larger version (0K): [in this window] [in a new window]   Figure 2. A, Intraoperative photograph of the heart. The anterior wall of the right atrium revealed a firm bulging mass just superior to the atrioventricular groove (main tumor) and extending to the superior vena cava (daughter tumor). RV indicates right ventricle; Ao, aorta. B, Gross photograph of the bisected tumor. The external surface is relatively smooth, and its cut surface is yellow. A small cyst is also seen in the middle of the bisected surface.

View larger version (0K): [in this window] [in a new window]   Figure 3. A, Microscopic section showing the typical Antoni type A tissue, with palisading of nuclei and fibers. B, A well-developed Antoni type B tissue. The tissue is less organized and is of loose texture (hematoxylin-eosin).

	Footnotes

 
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner, MC 4-265, Houston, TX 77030.

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This Article Extract Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kodama, M. Articles by Sakai, K. Search for Related Content PubMed PubMed Citation Articles by Kodama, M. Articles by Sakai, K.