Angiosarcoma of the heart: ultrastructural study

Calcified left ventricular mass: unusual clinical, echocardiographic, and computed tomographic findings of primary cardiac osteosarcoma

Primary cardiac osteosarcomas are rare and usually originate in the left atrium. In contrast, osteosarcomas metastatic to the heart most commonly involve the right cardiac chambers. This case report describes an unusual primary cardiac osteosarcoma, initially observed as a slowly growing, densely calcified mass of the left ventricle with subsequent secondary pulmonary metastasis. Although cardiac tumors may be asymptomatic, this patient had recurrent bouts of ventricular tachyarrhythmia. We describe the clinical, echocardiographic, and radiological observations spanning 6 years and the gross and microscopic features at autopsy.

Angiosarcoma of the heart: pericardial fluid cytology

The unique cytomorphologic aspects of a cardiac angiosarcoma in pericardial fluid are presented. Smears and cell block preparations revealed clusters of malignant pleomorphic oval to spindle-shaped cells concentrically layered about amorphous acellular cores. The cytologic findings were correlated with histologic, immunohistochemical, and electron microscopic findings in the necropsy material.

Cardiac neoplasms: current diagnosis, pathology, and therapy

Cardiac neoplasms remain enigmatic because of their rarity and protean clinical manifestations. Although surgery for benign cardiac neoplasms seems straightforward, certain difficulties in diagnosis and extirpation often exist. Newer diagnostic modalities including intraoperative transesophageal echocardiography seem promising and may provide better planning for the surgeon. Moreover, cardiac transplantation has provided relief for some patients with irresectable benign neoplasms. As ventricular arrhythmias may emanate from benign tumors, electrophysiologically guided extirpation may provide helpful control. Malignant cardiac tumors remain the true challenge, whether primary or metastatic, as little surgical or medical progress has resulted. This review examines nearly all diagnostic, pathological, histologic, and therapeutic aspects of benign and malignant cardiac tumors. Moreover, the various surgical approaches necessary for removal of resectable neoplasms are detailed.

Cardiac angiosarcomas. A review and a case report

Forty-five cases of cardiac angiosarcomas were reviewed, and the data were compared with those of a 1968 review of 41 other cases which revealed these tumors to be typically located within the right atrium as large symptomatic masses and to be rapidly fatal, with the diagnoses usually determined only at autopsy. The relationship of these tumors to Kaposi's sarcoma was also examined. The findings paralleled those of the previous review. Additionally, the following points emerged: With the aid of newer imaging techniques, localization, biopsy diagnosis and resection of the atrial tumors are now being achieved more often, with some improvement in survival. Like angiosarcomas of other organs, atrial angiosarcomas exhibit highly variable histologic patterns, which often overlap those of Kaposi's sarcoma, and may also present metastatic patterns simulating widespread Kaposi's sarcoma or malignant melanoma. In reported cases of classical, endemic, or epidemic Kaposi's sarcoma, cardiac lesions are uncommon and typically are small, asymptomatic, restricted to the epicardium/or pericardium and, thus, are clearly different, both clinically and pathologically, from the atrial tumor group. The justification for designating cases of the latter group as "primary cardiac Kaposi's sarcoma" is open to debate. A case report illustrates many of the above points.

Case of angiosarcoma of the nasal passage of the horse--ultrastructure and differential diagnosis from progressive haematoma

An angiosarcoma involving the right frontal and maxillary sinuses in a nine-year-old Thoroughbred mare was studied post mortem by light and electron microscopy. Important diagnostic features included malignant endothelial cells lining ill-defined vascular spaces, supported by other vasoformative elements. Rhabdomyoblasts were also found. The tumour is apparently rarely seen in the nasal passages of the horse.

Histogenesis of post-mastectomy angiosarcoma--an ultrastructural study

An example of post-mastectomy angiosarcoma was studied by electron microscopy to determine its histogenesis. Unequivocal evidence of endothelial differentiation was found in well and poorly differentiated areas. Positive staining for factor VIII related antigen and negative staining for epithelial membrane antigen further confirmed that the tumour was a true angiosarcoma rather than a peculiar form of carcinomatous metastasis.

Electron microscopic observations of hepatic and subcutaneous hemangiosarcomas induced in mice exposed to vinyl chloride monomer

Both subcutaneous and hepatic hemangiosarcomas were induced in mice exposed to vinyl chloride monomer, and for the first time, the ultrastructure of hemangiosarcomas related to vinyl chloride exposure has been described. The subcutaneous hemangiosarcoma developed in a mouse's ear 29 weeks after exposure to 10 ppm vinyl chloride for 4 weeks, and the hepatic hemangiosarcoma was found in a mouse's liver at necropsy 56 weeks after exposure to 600 ppm vinyl chloride for 4 weeks. Both tumors showed a localized, cystic nodular appearance with a dark red tone. Histologically, an angiomatous architecture, the presence of neoplastic mesenchymal cell aggregates, focal necrosis, and hemorrhagic foci were common. Ultrastructurally, two neoplastic cell types, a mesenchymal and a well-differentiated endothelial cell type, were identified in both tumors. In addition, in the hepatic tumor, a pericyte-like neoplastic cell was also present. The incidence of hemangiosarcoma was much lower than that of lung tumors (alveologenic tumor) in mice exposed to vinyl chloride at the same concentrations for the same duration. This study suggests that there is no basic difference in ultrastructure between the vinyl chloride-induced hemangiosarcomas and hemangiosarcomas not related to this chemical exposure.