PMC8573143_01
Image and tissue findings. (A) CMR 4 chamber image revealing an 8 x 6 mm mass in the lateral LV wall on the papillary muscle insertion and septal thickening (arrows). (B) CMR 4 chambers, 36 x 35 mm mass with diffuse enhancement occupying the totality of the LV apex (arrow). (C) Four-chamber echocardiogram, 8-mm hyperechoic, homogeneous, rounded mass on the lateral wall of the LV (arrow). (D) Micrograph of the first heart tumor. Some nuclear atypia can be seen and two "spider" cells (yellow arrows). Masson trichomic. 40x. (E) Micrograph of lymph node with tumoral cells in an alveolar pattern. On the lower left side of the image, the residual lymphatic tissue can be seen. H/E. 4x.
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F1
TTE was performed and revealed an 8-mm rounded hyperechoic apical mass that was corroborated by computed tomography (CT) (Figure 1). The patient rejected surgical intervention, and over the following 2 years, sporadic SVT episodes were reported on the 24-h Holter monitoring.
Immunohistochemistry. (A) Micrograph of the heart tumor with vimentin that shows negative staining (-): there is no evidence of vimentin in any of the cells. The brown staining in the vessels serves as a control. (B) Micrograph of the heart tumor with the HMN-45 marker that shows mild reactivity (+). <25% of the cells show staining. (C) Micrograph of the heart tumor that shows moderate reactivity (++) with synaptophysin staining. (D) Micrograph of the heart tumor that shows intense positivity (+++) for the MyoD1 marker.
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F2
The histopathologic study of the axillary nodule showed clear cells with eosinophilic cytoplasm, positive for HMB 45 and SMA and negative for vimentin and desmin (Figure 2).