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Cytogenetic Study of a Cardiac Papillary Fibroelastoma
Cytogenetic Study of a Cardiac Papillary Fibroelastoma
We read with interest the short communication of Speights et al. [1] concerning the cytogenetics of a case of a cardiac papillary fibroelastoma, and would like to report a second case. The patient is an 81-year-old male who sustained a left hemispheric embolic stroke, with right upper extremity weakness and mild dysphasia. A cardiac echocardiogram showed a left atrial mass. Cardiac catheterization showed significant coronary artery disease. The patient underwent a sternotomy, a coronary artery bypass graft, and resection of the left atrial mass and part of the atrial septum. The tumor was based on the atrial septum near the posteromedial commissure of the mitral valve. The postoperative course was unremarkable. The mass was a translucent, glistening, gray-tan, and fleshy-to-gelatinous nodule that measured 1.5 ⫻ 0.8 ⫻ 0.6 cm. Histologically, avascular, hypocellular papillae lined by an endothelial layer were seen to arise from the septum. Some papillae showed central hyalinization with a peripheral zone of myxoid stroma that was alcian-blue positive. Three milliliters of minced tissue were treated with collagenase (Sigma, St. Louis, MO, USA), cultured on chamber slides at 37⬚C in a 5% CO2 incubator, and harvested by standard in situ cytogenetic techniques at 7 days. GTG-banding was used. Ten cells were analyzed from each of two different cultures, both of which showed a stemline and a sideline clone. Seven cells displayed
Cancer Genet Cytogenet 120:174–175 (2000) 2000 Elsevier Science Inc.. All rights reserved. 655 Avenue of the Americas, New York, NY 10010
nullisomy Y and trisomy 12 [46,X,⫺Y,⫹12]. Thirteen cells showed a derivative chromosome that involved the centromeric fusion of 21q and a supernumerary copy of 5q, nullisomy Y, and trisomies 12 and 20 [47,X,⫺Y,⫹5, der(5;21)(q10;q10),⫹12,⫹20] (Fig. 1). The case was of interest because its cytogenetic findings differed from those of Speights et al. [1]. Although both cases showed a structural rearrangement involving chromosomes 5 and 21, this case showed an unbalanced rearrangement in only the sideline clone, whereas the prior case involved a balanced translocation in both stemline and sideline clones. The present case displayed numerical changes not seen in the prior case. The prior case showed an isochromosome not seen herein. Additional cases of papillary fibroelastoma should be analyzed to further clarify the cytogenetic changes that characterize this rare tumor. MITCHELL WACHTEL DEBORAH W. HERITAGE LUCIA PASTORE JOHN RHEE
American Medical Laboratories Chantilly, Virginia, USA Inova Fairfax Hospital Falls Church, Virginia, USA
REFERENCE 1. Speights VO, Dobin SM, Truss LM (1998): A cytogenetic study of a cardiac papillary fibroelastoma. Cancer Genet Cytogenet 103:167–169.
0165-4608/00/$–see front matter PII S0165-4608(00)00214-4
175
Cardiac Papillary Fibroelastoma
Figure 1 Karyotype of sideline clone.
We read with interest the short communication of Speights et al. [1] concerning the cytogenetics of a case of a cardiac papillary fibroelastoma, and would like to report a second case. The patient is an 81-year-old male who sustained a left hemispheric embolic stroke, with right upper extremity weakness and mild dysphasia. A cardiac echocardiogram showed a left atrial mass. Cardiac catheterization showed significant coronary artery disease. The patient underwent a sternotomy, a coronary artery bypass graft, and resection of the left atrial mass and part of the atrial septum. The tumor was based on the atrial septum near the posteromedial commissure of the mitral valve. The postoperative course was unremarkable. The mass was a translucent, glistening, gray-tan, and fleshy-to-gelatinous nodule that measured 1.5 ⫻ 0.8 ⫻ 0.6 cm. Histologically, avascular, hypocellular papillae lined by an endothelial layer were seen to arise from the septum. Some papillae showed central hyalinization with a peripheral zone of myxoid stroma that was alcian-blue positive. Three milliliters of minced tissue were treated with collagenase (Sigma, St. Louis, MO, USA), cultured on chamber slides at 37⬚C in a 5% CO2 incubator, and harvested by standard in situ cytogenetic techniques at 7 days. GTG-banding was used. Ten cells were analyzed from each of two different cultures, both of which showed a stemline and a sideline clone. Seven cells displayed
Cancer Genet Cytogenet 120:174–175 (2000) 2000 Elsevier Science Inc.. All rights reserved. 655 Avenue of the Americas, New York, NY 10010
nullisomy Y and trisomy 12 [46,X,⫺Y,⫹12]. Thirteen cells showed a derivative chromosome that involved the centromeric fusion of 21q and a supernumerary copy of 5q, nullisomy Y, and trisomies 12 and 20 [47,X,⫺Y,⫹5, der(5;21)(q10;q10),⫹12,⫹20] (Fig. 1). The case was of interest because its cytogenetic findings differed from those of Speights et al. [1]. Although both cases showed a structural rearrangement involving chromosomes 5 and 21, this case showed an unbalanced rearrangement in only the sideline clone, whereas the prior case involved a balanced translocation in both stemline and sideline clones. The present case displayed numerical changes not seen in the prior case. The prior case showed an isochromosome not seen herein. Additional cases of papillary fibroelastoma should be analyzed to further clarify the cytogenetic changes that characterize this rare tumor. MITCHELL WACHTEL DEBORAH W. HERITAGE LUCIA PASTORE JOHN RHEE
American Medical Laboratories Chantilly, Virginia, USA Inova Fairfax Hospital Falls Church, Virginia, USA
REFERENCE 1. Speights VO, Dobin SM, Truss LM (1998): A cytogenetic study of a cardiac papillary fibroelastoma. Cancer Genet Cytogenet 103:167–169.
0165-4608/00/$–see front matter PII S0165-4608(00)00214-4
175
Cardiac Papillary Fibroelastoma
Figure 1 Karyotype of sideline clone.