Grimmett Hannah J, Kimbimbi Ketsia, Greenberg Ava, Dar Niharika, Faridi Tavana Hadiseh, Abouzaid Kamal A, Imam Ahmad
Department of Anatomical Sciences, William Carey University College of Osteopathic Medicine, Hattiesburg, USA.
Cureus. 2024 Oct 18;16(10):e71794. doi: 10.7759/cureus.71794. eCollection 2024 Oct.
Primary cardiac tumors (PCTs) are rare and include myxomas, papillary fibroelastomas, rhabdomyomas, and lipomas. Lipomatous hypertrophy of the atrial septum (LHAS) is a benign condition associated with aging and obesity that is marked by fat accumulation in the interatrial septum and is caused by hyperplasia of adipose cells. In contrast, lipomas are characterized as soft masses of fat that are encapsulated by thin, fibrous tissue. True cardiac lipomas are rare and can present a diagnostic dilemma. Cardiac lipomas are generally asymptomatic but may present with angina, dyspnea, or syncope. Less frequently, they can cause arrhythmias, valve dysfunction, or emboli. Diagnosis generally requires cardiac MRI or alternate imaging modality. In this report, we present a case of a true atrial septal lipoma with a sessile base protruding into the right atrium discovered during the pedagogic dissection assignment of the interior of the heart. The tumor measured 0.5 × 1.0 cm, and on the cut surface, it appeared yellow and encapsulated. Histopathological examination of the lipomatous mass revealed extensive nodular thickening of the interatrial septum from the accumulation of mature adipose tissue reaching the resection surface. It is possible that the lipoma may have had a space-occupying effect, which would have increased the volume within the right atrium and had an adverse effect on tricuspid valve function. This is consistent with the dilated and thin-walled appearance of the right atrium. This report contributes to the limited literature on this type of benign, primary cardiac tumor and provides a clear illustration and clinical relevance to showcase the pathology and its possible clinical consequences.
原发性心脏肿瘤（PCTs）较为罕见，包括黏液瘤、乳头状纤维弹性瘤、横纹肌瘤和脂肪瘤。房间隔脂肪肥厚（LHAS）是一种与衰老和肥胖相关的良性病症，其特征是房间隔内脂肪堆积，由脂肪细胞增生引起。相比之下，脂肪瘤的特征是由薄纤维组织包裹的柔软脂肪块。真正的心脏脂肪瘤很罕见，可能会带来诊断难题。心脏脂肪瘤通常无症状，但可能出现心绞痛、呼吸困难或晕厥。较少见的情况下，它们可导致心律失常、瓣膜功能障碍或栓子形成。诊断通常需要心脏磁共振成像（MRI）或其他成像方式。在本报告中，我们呈现了一例在心脏内部教学解剖过程中发现的真正的房间隔脂肪瘤病例，其基底呈无蒂状，突入右心房。肿瘤大小为0.5×1.0厘米，切面呈黄色且有包膜。对脂肪瘤块进行组织病理学检查发现，由于成熟脂肪组织堆积，房间隔出现广泛的结节性增厚并延伸至切除表面。脂肪瘤可能产生了占位效应，这会增加右心房内的容积并对三尖瓣功能产生不利影响。这与右心房扩张且壁薄的外观相符。本报告丰富了关于这类良性原发性心脏肿瘤的有限文献，并提供了清晰的图示和临床相关性，以展示其病理及其可能的临床后果。
