Kasugai T, Sakurai M, Yutani C, Hirota S, Waki N, Adachi S, Kitamura Y
Department of Pathology, Osaka University Medical School, Japan.
Acta Pathol Jpn. 1990 Sep;40(9):687-92. doi: 10.1111/j.1440-1827.1990.tb01617.x.
We describe a case of cardiac myxoma in a 44-year-old Japanese man, who died after developing metastases in the skin, brain and muscle. A satellite tumor which was attached to the wall of the abdominal aorta induced marked hypertension due to obstruction of the renal arteries. Although the primary heart tumor had typical histological features of benign cardiac myxoma, the recurrent heart tumor, which was partly resected three months before the patient's death, showed apparently malignant characteristics resembling malignant fibrous histiocytoma (MFH). Since the histological features of the initial and recurrent tumors were different, the grade of malignancy was investigated using the cellularity of the tumor as an arbitrary criterion. A gradual but significant increase in the cellularity was observed over the course of five years. Immunohistochemically, tumor cells in the muscle metastasis contained vimentin and factor VIII-related antigen, and multinucleated giant cells in the recurrent heart tumor contained desmin, which is rarely detectable in MFH. Therefore, we considered that the present case represented malignant transformation of benign cardiac myxoma.
我们描述了一例44岁日本男性的心脏黏液瘤病例，该患者在皮肤、脑和肌肉出现转移后死亡。一个附着于腹主动脉壁的卫星肿瘤因肾动脉阻塞导致显著高血压。尽管原发性心脏肿瘤具有典型的良性心脏黏液瘤组织学特征，但在患者死亡前三个月部分切除的复发性心脏肿瘤表现出类似恶性纤维组织细胞瘤（MFH）的明显恶性特征。由于初始肿瘤和复发性肿瘤的组织学特征不同，以肿瘤细胞密度作为任意标准来研究恶性程度。在五年期间观察到细胞密度逐渐但显著增加。免疫组织化学显示，肌肉转移灶中的肿瘤细胞含有波形蛋白和因子VIII相关抗原，而复发性心脏肿瘤中的多核巨细胞含有结蛋白，这在MFH中很少能检测到。因此，我们认为该病例代表了良性心脏黏液瘤的恶性转化。
