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Everything you need to know about Computed Tomography (CT) & CT Scanning


question

Question 16: 50ish year old female with a history of fatigue and weight loss. Patient also had abnormal cardiac echo. What is the diagnosis?

answer

Diagnosis: Left Atrial Myxoma

 

Atrial Myxoma: facts

  • Most common benign tumor of the heart
  • 85% are in left atrium attached to atrial septum near fossa ovalis
  • Calcification is seen in half the patients

Left Atrial Myxoma: Facts

  • Average age is 50
  • Woman are more likely to have this mass (60%)
  • Calcification is seen in half the patients
  • These lesions are usually sporadic in occurrence but there is a familial occurrence as well (10% of cases)

Atrial Myxoma: Differential Diagnosis

  • Intracardiac thrombus
  • Cardiac metastasis
  • Cardiac lipoma
  • Primary cardiac malignancies
  • Cardiac lymphoma

Atrial Myxoma: Clinical presentation

  • Valvular obstruction (40%)-dyspnea, edema
  • Constitutional (30%)- fatigue, FUO, weight loss
  • Embolic events (30%)- including emboli to the brain

Differential Dx: Right Atrial Mass

  • Intracardiac thrombosis
  • Atrial myxoma (15% of myxomas)
  • Metastases including direct tumor extension (renal,adrenal and hepatoma)
  • lymphoma

Atrial Myxoma

 

Left Atrial Myxoma

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cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdct 

 

Atrial Myxomas:Facts

  • 4x more commonly in left atrium when compared to the right atrium
  • Can grow thru the fossa ovalis and therefore be in both right and left atrium
  • Tumor can result in emboli to heart or brain

 

Clot in Right Atrium

cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdctcardiac 64 mdct

 

Clot in Left Atrium simulates a Myxoma

cardiac 64 mdctcardiac 64 mdct
cardiac 64 mdct 

 

© 1999-2019 Elliot K. Fishman, MD, FACR. All rights reserved.