Unusual Left Ventricular Mass
A20-year-old man, previously asymptomatic, showed an incidental finding at echocardiography of a left ventricular mass. In the Figure⇓, A is a two-dimensional echocardiogram in the apical four-chamber view showing a round mass (arrow), scarcely mobile, attached to the left ventricular anterolateral free wall. B shows the gross appearance of the mass removed at surgery: it looks soft and sessile, with a smooth surface, and is 10×15×15 mm in size and 2 g in weight. C, At histology, the tumor consists of a myxoid Alcian-positive matrix and polygonal cells forming capillary-like channels (Alcian PAS stain; magnification ×200). D, At immunohistochemistry, the cells lining the capillary-like channels show a strong positivity for factor VIII–related antigen (ABC; magnification ×200).
The final diagnosis is left ventricular myxoma with prevalent angioblastic features (so-called “benign myxomatous endothelioma”).
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 Ave, MC1–267, Houston, TX 77030.
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