PMC8351648_01
Electrocardiogram and multimodality imaging approach of undifferentiated pleomorphic cardiac sarcoma. A: 12-lead electrocardiogram shows sinus tachycardia; B: chest X-ray with Grade II venocapillary hypertension and pleural effusion; C: four chambers image by transthoracic echocardiogram, showing intracardiac mass (arrow) located in the left atrium; D: transesophageal echocardiogram confirms mass in the left atrium (solid arrow) adhered to the posterior wall of 48 mm x 34 mm and E: Doppler color showed obstruction of the left ventricle inflow tract (dashed arrow).
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F1
At physical examination, there was mitral regurgitant murmur Grade III and bilateral crepitation rales; the electrocardiogram detected sinus tachycardia (Fig. 1A) and X-ray showed Grade II venocapillary hypertension and pleural effusion (Fig. 1B). The echocardiogram revealed an intracardiac mass in the left atrium of 36 mm x 48 mm, protruding through the mitral valve, conditioning moderate stenosis and severe insufficiency (Fig. 1C-E).
Histological sections of undifferentiated pleomorphic cardiac sarcoma. A: the neoplastic cells have an epithelioid or spindle cell appearance with pleomorphic nuclei, atypical mitosis, and scarce lymphocytic infiltrate (HE, 400 x); B: extensive myocardial infiltration is shown by pleomorphic neoplasm with a solid pattern (HE, 100 x); C: immunohistochemical staining with positive cytoplasmic anti-vimentin antibody (ocher color) in most of the neoplastic cells (100 x). HE: Hematoxylin-eosin.
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F2
The histological sections showed a solid-appearing neoplastic proliferative lesion with lax isolated areas of myxoid appearance, short cellular bundles, and branched vessels with extensive myocardial infiltration and infiltration of the valvular tissue (Fig. 2A-C).