Skip to main content

Novelties in Immunohistochemical and Molecular Study of Cardiac Tumors

  • Chapter
  • First Online:

Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

Cardiac tumors are rare entities [1, 2]. Because of the rarity, it is difficult to investigate systematically large series of cardiac tumors using ancillary or biomolecular and experimental methods of investigation. As a consequence, scarce innovative information is available concerning the histogenesis of the majority of cardiac tumors. Myxomas are the most frequent neoplasms, accounting for 50 % of all tumors (Reynen K. N Engl J Med 333:1610–17, 1995; Burke AP, Virmani R. Atlas of tumor pathology, 3rd ed. Armed Forced Institute of Pathology: Washington, DC. p. 121–46, 1996), and the most investigated primary cardiac tumor. Nevertheless, the origin of myxoma remains uncertain. In this chapter, we summarize the most recent novelties in the biomolecular and immunohistochemical investigation of primary cardiac tumors.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Reynen K. Cardiac myxomas. N Engl J Med. 1995;333:1610–7.

    Article  CAS  PubMed  Google Scholar 

  2. Burke AP, Virmani R. Tumors of the heart and great vessels. In: Burke AP, Virmani R, editors. Atlas of tumor pathology. 3rd ed. Washington DC: Armed Forced Institute of Pathology; 1996. p. 121–46.

    Google Scholar 

  3. Lie JT. The identity and histogenesis of cardiac myxomas. A controversy put to rest. Arch Pathol Lab Med. 1989;113:724–6.

    CAS  PubMed  Google Scholar 

  4. Tazelaar HD, Locke TJ, McGregor CG. Pathology of surgically excised primary cardiac tumors. Mayo Clin Proc. 1992;67:957–65.

    CAS  PubMed  Google Scholar 

  5. Boxer ME. Cardiac myxoma: an immunoperoxidase study of histogenesis. Histopathology. 1984;8:861–72.

    Article  CAS  PubMed  Google Scholar 

  6. Goldman BI, Frydman C, Harpaz N, Ryan SF, Loiterman D. Glandular cardiac myxomas. Histologic, immunohistochemical, and ultrastructural evidence of epithelial differentiation. Cancer. 1987;59:1767–75.

    Article  CAS  PubMed  Google Scholar 

  7. Govoni E, Severi B, Cenacchi G, Laschi R, Pileri S, Rivano MT, Alampi G, Branzi A. Ultrastructural and immunohistochemical contribution to the histogenesis of human cardiac myxoma. Ultrastruct Pathol. 1988;12:221–33.

    Article  CAS  PubMed  Google Scholar 

  8. Landon G, Ordonez NG, Guarda LA. Cardiac myxomas. An immunohistochemical study using endothelial, histiocytic, and smooth-muscle cell markers. Arch Pathol Lab Med. 1986;110:116–20.

    CAS  PubMed  Google Scholar 

  9. Pucci A, Gagliardotto P, Zanini C, Pansini S, di Summa M, Mollo F. Histopathologic and clinical characterization of cardiac myxoma: review of 53 cases from a single institution. Am Heart J. 2000;140:134–8.

    Article  CAS  PubMed  Google Scholar 

  10. McComb RD. Heterogeneous expression of factor VIII/von Willebrand factor by cardiac myxoma cells. Am J Surg Pathol. 1984;8:539–44.

    Article  CAS  PubMed  Google Scholar 

  11. Vandekerckhove J, Bugaisky G, Buckingham M. Simultaneous expression of skeletal muscle and heart actin proteins in various striated muscle tissues and cells. A quantitative determination of the two actin isoforms. J Biol Chem. 1986;261:1838–43.

    CAS  PubMed  Google Scholar 

  12. Suurmeijer AJ, Clement S, Francesconi A, Bocchi L, Angelini A, Van Veldhuisen DJ, Spagnoli LG, Gabbiani G, Orlandi A. Alpha-actin isoform distribution in normal and failing human heart: a morphological, morphometric, and biochemical study. J Pathol. 2003;199:387–97.

    Article  CAS  PubMed  Google Scholar 

  13. Orlandi A, Ciucci A, Ferlosio A, Genta R, Spagnoli LG, Gabbiani G. Cardiac myxoma cells exhibit embryonic endocardial stem cell features. J Pathol. 2006;209:231–9.

    Article  CAS  PubMed  Google Scholar 

  14. Ha JW, Kang WC, Chung N, Chang BC, Rim SJ, Kwon JW, Jang Y, Shim WH, Cho SY, Kim SS, Cho SH. Echocardiographic and morphologic characteristics of left atrial myxoma and their relation to systemic embolism. Am J Cardiol. 1999;83:1579–82.

    Article  CAS  PubMed  Google Scholar 

  15. Kairemo KJ, Blomqvist CP, Miettinen M. Cardiac myxomas. N Engl J Med. 1996;334:1407–8.

    CAS  PubMed  Google Scholar 

  16. Negishi M, Sakamoto H, Sakamaki T, Ishikawa O, Kanda T, Tamura J, Kurabayashi M, Nagai R. Disaccharide analysis of glycosaminoglycans synthesized by cardiac myxoma cells in tumor tissues and in cell culture. Life Sci. 2003;73:849–56.

    Article  CAS  PubMed  Google Scholar 

  17. Parissis JT, Mentzikof D, Georgopoulou M, Gikopoulos M, Kanapitsas A, Merkouris K, Kefalas C. Correlation of interleukin-6 gene expression to immunologic features in patients with cardiac myxomas. J Interferon Cytokine Res. 1996;16:589–93.

    Article  CAS  PubMed  Google Scholar 

  18. Suzuki M, Hamada M, Hiwada K. Apoptosis in cardiac myxoma. Ann Intern Med. 2000;132:681.

    CAS  PubMed  Google Scholar 

  19. Liu CC, Jung SM, Orlandi A, Yeh TS, Lin YS, Shiu TF, Wu HH, Chu JJ, Lin PJ, Chu PH. The Fas-mediated apoptotic pathway in cardiac myxoma. Int J Surg Pathol. 2010;18:493–8.

    CAS  PubMed  Google Scholar 

  20. Orlandi A, Ciucci A, Ferlosio A, Pellegrino A, Chiariello L, Spagnoli LG. Increased expression and activity of matrix metalloproteinases characterize embolic cardiac myxomas. Am J Pathol. 2005;166:1619–28.

    Article  CAS  PubMed  Google Scholar 

  21. Oh J, Takahashi R, Kondo S, Mizoguchi A, Adachi E, Sasahara RM, Nishimura S, Imamura Y, Kitayama H, Alexander DB, Ide C, Horan TP, Arakawa T, Yoshida H, Nishikawa S, Itoh Y, Seiki M, Itohara S, Takahashi C, Noda M. The membrane-anchored MMP inhibitor RECK is a key regulator of extracellular matrix integrity and angiogenesis. Cell. 2001;107:789–800.

    Article  CAS  PubMed  Google Scholar 

  22. Dollery CM, McEwan JR, Henney AM. Matrix metalloproteinases and cardiovascular disease. Circ Res. 1995;77:863–8.

    Article  CAS  PubMed  Google Scholar 

  23. Singer CF, Kronsteiner N, Marton E, Kubista M, Cullen KJ, Hirtenlehner K, Seifert M, Kubista E. MMP-2 and MMP-9 expression in breast cancer-derived human fibroblasts is differentially regulated by stromal–epithelial interactions. Breast Cancer Res Treat. 2002;72:69–77.

    Article  CAS  PubMed  Google Scholar 

  24. Markwald RR, Fitzharris TP, Manasek FJ. Structural development of endocardial cushions. Am J Anat 1977;148:85–119.

    CAS  PubMed  Google Scholar 

  25. Kodama H, Hirotani T, Suzuki Y, Ogawa S, Yamazaki K. Cardiomyogenic differentiation in cardiac myxoma expressing lineage-specific transcription factors. Am J Pathol. 2002;161:381–9.

    CAS  PubMed  Google Scholar 

  26. Schwartz RJ, Olson EN. Building the heart piece by piece: modularity of cis-elements regulating Nkx2.5 transcription. Development. 1999;126:4187–92.

    Article  CAS  PubMed  Google Scholar 

  27. Riazi AM, Lee H, Hsu C, Van Arsdell G. CSX/Nkx2.5 modulates differentiation of skeletal myoblasts and promotes differentiation into neuronal cells in vitro. J Biol Chem. 2005;280:10716–20.

    CAS  PubMed  Google Scholar 

  28. Sugi Y, Lough J. Onset of expression and regional deposition of alpha-smooth and sarcomeric actin during avian heart development. Dev Dyn. 1992;193:116–24.

    Article  CAS  PubMed  Google Scholar 

  29. Valente M. Structural profile of cardiac myxoma. Appl Pathol. 1983;1:251–63.

    Article  CAS  PubMed  Google Scholar 

  30. Zhang PF, Jones JW, Anderson WR. Cardiac myxomas correlative study by light, transmission, and scanning electron microscopy. Am J Cardiovasc Pathol. 1989;2:295–300.

    CAS  PubMed  Google Scholar 

  31. Sugi Y, Markwald RR. Formation and early morphogenesis of endocardial endothelial precursor cells and the role of endoderm. Dev Biol. 1996;175:66–83.

    CAS  PubMed  Google Scholar 

  32. Gitler AD, Lu MM, Jiang YQ, Epstein JA, Gruber PJ. Molecular markers of cardiac endocardial cushion development. Dev Dyn. 2003;228:643–50.

    Article  CAS  PubMed  Google Scholar 

  33. Nakajima Y, Mironov V, Yamagishi T, Nakamura H, Markwald RR. Expression of smooth muscle ­alpha-actin in mesenchymal cells during formation of avian endocardial cushion tissue: a role for transforming growth factor beta3. Dev Dyn. 1997;209:296–309.

    Article  CAS  PubMed  Google Scholar 

  34. Moorman A, Webb S, Brown NA, Lamers W, Anderson RH. Development of the heart: (1) formation of the cardiac chambers and arterial trunks. Heart. 2003;89:806–14.

    Article  CAS  PubMed  Google Scholar 

  35. Noseda M, McLean G, Niessen K, Chang L, Pollet I, Montpetit R, Shahidi R, Dorovini-Zis K, Li L, Beckstead B, Durand RE, Hoodless PA, Karsan A. Notch activation results in phenotypic and functional changes consistent with endothelial-to-mesenchymal transformation. Circ Res. 2004;94:910–7.

    Article  CAS  PubMed  Google Scholar 

  36. Akiyama H, Chaboissier MC, Behringer RR, Rowitch DH, Schedl A, Epstein JA, de Crombrugghe B. Essential role of Sox9 in the pathway that controls formation of cardiac valves and septa. Proc Natl Acad Sci USA. 2004;101:6502–7.

    Article  CAS  PubMed  Google Scholar 

  37. Ranger AM, Grusby MJ, Hodge MR, Gravallese EM, de la Brousse FC, Hoey T, Mickanin C, Baldwin HS, Glimcher LH. The transcription factor NF-ATc is essential for cardiac valve formation. Nature. 1998;392:186–90.

    Article  CAS  PubMed  Google Scholar 

  38. Carney JA, Gordon H, Carpenter PC, Shenoy BV, Go VL. The complex of myxomas, spotty pigmentation, and endocrine overactivity. Medicine (Baltimore). 1985;64:270–83.

    CAS  Google Scholar 

  39. Pinede L, Duhaut P, Loire R. Clinical presentation of left atrial cardiac myxoma: a series of 112 consecutive cases. Medicine (Baltimore). 2001;80:159–72.

    Article  CAS  Google Scholar 

  40. Stratakis CA, Carney JA, Lin JP, Papanicolaou DA, Karl M, Kastner DL, Pras E, Chrousos GP. Carney complex, a familial multiple neoplasia and lentiginosis syndrome: analysis of 11 kindreds and linkage to the short arm of chromosome 2. J Clin Invest. 1996;97:699–705.

    Article  CAS  PubMed  Google Scholar 

  41. Dijkuizen T, van den Berg E, Molenaar WM, Meuzelaar JJ, de Jong B. Rearrangements involving 12p12 in two cases of cardiac myxoma. Cancer Genet Cytogenet. 1995;82:161–2.

    Article  Google Scholar 

  42. Kirscher LS, Carney JA, Pack SD, Taymans SE, Giatzakis C, Cho YS, Cho-Chung YS, Stratakis CA. Mutations of the gene encoding the protein kinase A type I-alpha regulatory subunit in patients with the Carney complex. Nat Genet. 2000;26:89–92.

    Article  Google Scholar 

  43. Grebenc ML, Rosado-de-Christenson ML, Green CE, Burke AP, Galvin JR. Cardiac myxoma: imaging features in 83 patients. Radiographics. 2002;22:673–89.

    PubMed  Google Scholar 

  44. Curatolo P, Bombardieri R, Jozwiak S. Tuberous sclerosis. Lancet. 2008;372:57–668.

    Article  Google Scholar 

  45. Wilkes D, Charitakis K, Basson CT. Inherited disposition to cardiac myxoma development. Nat Rev Cancer. 2006;6:157–65.

    Article  CAS  PubMed  Google Scholar 

  46. Lo Muzio L. Nevoid basal cell carcinoma syndrome (Gorlin syndrome). Orphanet J Rare Dis. 2008;3:32.

    Article  PubMed  Google Scholar 

  47. Callender GG, Rich TA, Perrier ND. Multiple endocrine neoplasia syndromes. Surg Clin North Am. 2008;88:863–95.

    Article  PubMed  Google Scholar 

  48. Vaughan CJ, Weremowicz S, Goldstein MM, Casey M, Hart M, Hahn RT, Devereux RB, Girardi L, Schoen FJ, Fletcher JA, Morton CC, Basson CT. A t(2;19)(p13; p13.2) in a giant invasive cardiac lipoma from a patient with multiple lipomatosis. Genes Chromosomes Cancer. 2000;28:133–7.

    Article  CAS  PubMed  Google Scholar 

  49. Madueme P, Hinton R. Tuberous sclerosis and cardiac rhabdomyomas: a case report and review of the literature. Congenit Heart Dis. 2011;6:183–7.

    Article  PubMed  Google Scholar 

  50. Evans DG, Ladusans EJ, Rimmer S, Burnell LD, Thakker N, Farndon PA. Complications of the naevoid basal cell carcinoma syndrome: results of a population based study. J Med Genet. 1993;30:460–4.

    Article  CAS  PubMed  Google Scholar 

  51. Gorlin RJ. Nevoid basal cell carcinoma (Gorlin) syndrome. Genet Med. 2004;6:530–9.

    Article  PubMed  Google Scholar 

  52. Orlandi A, Ferlosio A, Roselli M, Chiariello L, Spagnoli LG. Cardiac sarcomas: an update. J Thorac Oncol. 2010;9:1483–9.

    Article  Google Scholar 

  53. Lymbumer R. Tumours of the heart: histopathological and clinical study. Can Med Assoc J. 1934;30:368–73.

    Google Scholar 

  54. Burke A, Veinot J, Loire R. Tumours of the heart. In: Travis W, Brambilla E, Müller H, Harris C, editors. Tumours of the lung, pleura, thymus and heart. Lyon: IARC Press; 2004. p. 251–88.

    Google Scholar 

  55. Mazzola A, Spano JP, Valente M, Gregoriani R, Villani C, Di Eusanio M, Ciocca M, Minuti U, Giancola R, Basso C, Thiene G. Leiomyosarcoma of the left atrium mimicking a left atrial myxoma. J Thorac Cardiovasc Surg. 2006;131:224–6.

    CAS  PubMed  Google Scholar 

  56. Basso C, Valente M, Poletti A, Casarotto D, Thiene G. Surgical pathology of primary cardiac and pericardial tumors. Eur J Cardiothorac Surg. 1997;12:730–7.

    Article  CAS  PubMed  Google Scholar 

  57. Castorino F, Masiello P, Quattrocchi E, Di Benedetto G. Primary cardiac rhabdomyosarcoma of the left atrium: an unusual presentation. Tex Heart Inst J. 2000;27:206–8.

    CAS  PubMed  Google Scholar 

  58. Cessna MH, Zhou H, Perkins SL, Tripp SR, Layfield L, Daines C, Coffin CM. Are myogenin and myoD1 expression specific for rhabdomyosarcoma? A study of 150 cases, with emphasis on spindle cell mimics. Am J Surg Pathol. 2001;25:1150–7.

    Article  CAS  PubMed  Google Scholar 

  59. Garcia JM, Gonzalez R, Silva JM, Dominguez G, Vegazo IS, Gamallo C, Provencio M, España P, Bonilla F. Mutational status of K-ras and TP53 genes in primary sarcomas of the heart. Br J Cancer. 2000;82:1183–5.

    Article  CAS  PubMed  Google Scholar 

  60. Naka N, Tomita Y, Nakanishi H, Araki N, Hongyo T, Ochi T, Aozasa K. Mutations of p53 tumor-suppressor gene in angiosarcoma. Int J Cancer. 1997;71:952–5.

    Article  CAS  PubMed  Google Scholar 

  61. Amary MF, Berisha F, Bernardi Fdel C, Herbert A, James M, Reis-Filho JS, Fisher C, Nicholson AG, Tirabosco R, Diss TC, Flanagan AM. Detection of SS18-SSX fusion transcripts in formalin-fixed paraffin-embedded neoplasms: analysis of conventional RT-PCR, qRT-PCR and dual color FISH as diagnostic tools for synovial sarcoma. Mod Pathol. 2007;20:482–96.

    Article  CAS  PubMed  Google Scholar 

  62. Hazelbag HM, Szuhai K, Tanke HJ, Rosenberg C, Hogendoorn PC. Primary synovial sarcoma of the heart: a cytogenetic and molecular genetic analysis combining RT-PCR and COBRA-FISH of a case with a complex karyotype. Mod Pathol. 2004;17:1434–9.

    Article  PubMed  Google Scholar 

  63. Miller DV, Deb A, Edwards WD, Zehr KJ, Oliveira AM. Primary synovial sarcoma of the mitral valve. Cardiovasc Pathol. 2005;14:331–3.

    Article  PubMed  Google Scholar 

  64. Mertens F, Fletcher CD, Antonescu CR, Coindre JM, Colecchia M, Domanski HA, Downs-Kelly E, Fisher C, Goldblum JR, Guillou L, Reid R, Rosai J, Sciot R, Mandahl N, Panagopoulos I. Clinico­pathologic and molecular genetic characterization of low-grade fibromyxoid sarcoma, and cloning of a novel FUS/CREB3L1 fusion gene. Lab Invest. 2005;85:408–15.

    Article  CAS  PubMed  Google Scholar 

  65. Jakowski JD, Wakely Jr PE. Primary intrathoracic low-grade fibromyxoid sarcoma. Hum Pathol. 2008;39:623–8.

    Article  PubMed  Google Scholar 

  66. Palmer JL, Masui S, Pritchard S, Kalousek DK, Sorensen PH. Cytogenetic and molecular genetic analysis of a pediatric pleomorphic sarcoma reveals similarities to adult malignant fibrous histiocytoma. Cancer Genet Cytogenet. 1997;95:141–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Augusto Orlandi M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Orlandi, A., Spagnoli, L.G. (2013). Novelties in Immunohistochemical and Molecular Study of Cardiac Tumors. In: Basso, C., Valente, M., Thiene, G. (eds) Cardiac Tumor Pathology. Current Clinical Pathology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-143-1_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-62703-143-1_13

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-142-4

  • Online ISBN: 978-1-62703-143-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics