Deniz NART, FUNDA YILMAZ BARBET, Gül YÜCE, Hakan POSACIOĞLU, Yeşim ERTAN

Femoral arter embolisinin ilk semptom olduğu sol atrial miksoma: Olgu sunumu

Kardiak miksomalar en sık görülen primer kalp tümörleridir ve sol atrial yerleşimli olduklarında sıklıkla sistemik emboliye neden olurlar. Sol bacakta emboliye bağlı akut iskemik değişikliklerle başvuran kardiak miksomalı genç bir olgu sunuldu. Embolinin histolojik incelemesinde, trombüs alanları yanısıra, miksoid zeminde iğsi, yer yer yıldızsı, hiperkromatik hücrelerin görülmesi nedeniyle kardiak miksomanın sistemik embolizasyonu olabileceği düşünüldü. Transtorasik iki boyutlu ekokardiyografide primer kardiak tümör tespit edildi. Cerrahi eksizyon materyalinde miksoma tanısı kanıtlandı. Ayrıca, immunhistokimyasal olarak, kardiak miksoma ile miksoid trombüs ayırıcı tanısının yapılmasında kalretinin antikoru kullanıldı. Embolizasyona zemin hazırlayacak aritmi ve aterosklerozu bulunmayan genç hastalarda periferik embolilerin nedeni olarak sol atrial miksomalardan şüphelenilmelidir. Ayrıca kardiak miksoma ve miksoid trombüs ayırıcı tanısında immunhistokimyasal olarak kalretinin antikoru önemli bir role sahiptir.

Anahtar Kelimeler:

Femoral arter, Miksom, Emboli, İmmünohistokimya

Femoral arterial embolus as first presentation of left atrial myxoma: Case report

Cardiac myxomas are the most common primary tumor of the heart and they cause systemic embolization if they are located in the left atrium. We report a young case of cardiac myxoma presenting as acute ischemia of limb due to embolic phenomena. In histological study, besides the thrombus, there were stellate and fusiform cells with hiperchromatic nuclei in a myxoid matrix. It was thought that it could be systemic embolization of a cardiac myxoma.Transthoracic two dimensinal cardiac echocardiography showed the primary cardiac tumor. The cardiac myxoma diagnosis was also confirmed in surgical specimen. Calretinin antibody was used in the differential diagnosis of cardiac myxoma and a myxoid thrombus. Left atrial myxoma should be suspected as a cause of systemic embolization in young patients without arrhythmia and atherosclerosis. Calretinin antibody is a useful marker in differential diagnosis of cardiac myxoma and myxoid thrombus.

Keywords:

Femoral Artery, Myxoma, Embolism, Immunohistochemistry,

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