右心房黏液瘤临床病理分析并文献复习

Clinicopathologic analyses of right cardiac myxoma and review of the literature

目的:探讨右心房黏液瘤的临床病理学特点及诊断要点。方法:对2例右心房黏液瘤进行临床资料、病理形态学及免疫组织化学观察,并结合文献对其诊断及鉴别诊断进行探讨。结果:镜下黏液瘤细胞呈单个散在、条索状或呈血管形成的指环样结构排列,黏液样基质在血管周围形成晕环;瘤细胞形成原始或分化的血管趋势,基质内淋巴细胞、浆细胞浸润;瘤细胞细长、梭形或星状,胞浆嗜酸性,胞核卵圆形、圆形或细长形;瘤细胞聚集呈球状,胞浆嗜酸性,胞核卵圆形或梭形。结论:右心房黏液瘤,非常少见,因此缺乏对其认识,从而易与其他肿瘤混淆导致误诊。提高对心房黏液瘤的认识,对避免误诊是至关重要的。

Objective： To explore the characteristics of clinicopathology and diagnostic criteria about right cardiac myxoma. Methods： Analysed the features of clinicopathology and immunohistochemistry of 2 cases, and reviewed the literatures to investigate the diagnosis and its differential diagnosis. Results： Microscopically, mucus tumor cells were isolated, the funicular or arranged in a ring structure of blood vessel formation, myxoid matrix form haloes around blood vessels; the differentiation of tumor cells to form the original or vascular trend, lymphocytic and plasma cell infiltrates in the substrate; tumor cells elongated, fusiform or stellate, eosinophilic cytoplasm and nucleus ovoid, round or elongated; tumor cell aggregation spherical, eosinophilic cytoplasm and nucleus ovoid or fusiform. Conclusion： Right cardiac myxoma is very rare and lack of awareness, thus easily confused with other tumor leading to misdiagnosis. It is essential to avoid misdiagnosis with raising awareness.