心脏黏液瘤28例临床病理观察并文献复习  

Clinicopathological observation of 28 cardiac myxoma cases and review of the literature

作　　者：田素荣 蔡宇翔 TIAN Surong;CAI Yuxiang(Dept.of Cardiology,The First People's Hospital of Jiangxia District of Wuhan&Union Jiangnan Hospital,Huangzhong University of Science and Technology,Wuhan 430200,Hubei,China;Dept.of Pathology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉市江夏区第一人民医院/华中科技大学协和江南医院心内科,湖北武汉430200 [2]武汉大学中南医院病理科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2022年第6期952-956,共5页Medical Journal of Wuhan University

摘　　要：目的:分析28例心脏黏液瘤的病理结果,并结合相关文献对其临床病理特征,特别是不典型病理特征进行探讨。结果:研究共纳入28个病例,其中男性11例,女性17例,男女比约为0.6∶1,平均年龄51.3岁。主要临床表现包括胸闷、胸痛、心悸,部分病例没有症状,为偶然发现。28例肿瘤均为单发。其中左心房20例,右心房5例,左心室2例,右心室1例。病理形态:瘤细胞单个、条索状或簇状分布,部分瘤细胞沿血管呈同心圆套管状分布,血管周围可见黏液基质形成的晕环。1例心脏黏液瘤除经典病理形态外还可见腺样成分,腺样成分由单层或复层柱状上皮构成,可见散在杯状细胞。结论:心脏黏液瘤完整切除肿瘤后大部分患者可以治愈。出现腺样成分并不意味着肿瘤具有特殊的生物学行为,其具有与经典心脏黏液瘤相同的临床经过。心脏黏液瘤伴腺样分化一般表现为良性的生物学行为,极少数病例可发生转移。Objective:To analyze the pathological results of 28 cardiac myxoma cases,and to discuss the clinicopathological features,especially the nonclassical pathological features,in combination with the relevant literature.Results:A total of 28 cases were involved in the study,including 11 males and 17 females,with a male⁃to⁃female ratio of 0.6∶1 and mean age of 51.3 years.The main clinical manifes⁃tations included chest tightness,chest pain,palpitations,and some cases are asymptomatic and identi⁃fied incidentally.All of the 28 cardiac myxomas were solitary,and among them,20 were located in left atrium,5 in right atrium,2 in left ventricle,and 1 in right ventricle.Pathologically,tumor cells were distributed in single,cord⁃like or cluster⁃like pattern,and some tumor cells were distributed in concentric sleeve⁃like distribution along blood vessels,and a halo formed by mucinous matrix could be seen around blood vessels.In one case of cardiac myxoma,adenoid components were also seen be⁃sides the classic pathological morphology.The adenoid components were composed of monolayer or stratified columnar epithelia with scattered goblet cells.Conclusion:Most patients with cardiac myxo⁃ma can be cured after complete tumor resection.The presence of adenoid components in cardiac myx⁃oma does not imply a special biological behavior,and it has the same clinical course as classical cardi⁃ac myxoma.Cardiac myxoma with adenoid differentiation generally presents a benign biological be⁃havior with rare cases of metastasis.

关 键 词：心脏黏液瘤 心脏黏液瘤伴腺样分化 免疫组化 文献复习 

分 类 号：R732.1[医药卫生—肿瘤]