Lipomatous Hypertrophy of the Atrial Septum
A 74-year-old woman with a history of lung tuberculosis, peptic ulcer, diabetes mellitus (type 2), and progressive deterioration of psychomotor activity died after admission to hospital for acute bronchitis.
A basal ECG showed sinus rhythm, heart rate of 88 bpm, and P-wave abnormalities consisting of amplitude >2.5 mm in lead II, duration >100 ms, and “notching” configuration.
Lipomatous hypertrophy of the atrial septum was found incidentally at autopsy, with a mass 3×2 cm in size.
In vitro nuclear magnetic resonance of a heart specimen showed (Fig 1a) a round mass of bright intensity similar to epicardial fat within the atrial septum, corresponding to the grossly evident lipomatous accumulation (Fig 1b).1 2
At histological examination (Fig 1c), the nonencapsulated mass contained mature adipocytes with intermingled myocytes and mild interstitial fibrosis (Azan stain).
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