case_images: PMC10746877_01
case_images: plain chest X-ray (anterior-posterior view) showing features of bilateral pulmonary edema
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case_images: F1
case_images: A plain chest X-ray revealed features consistent with bilateral pulmonary edema, including diffuse air-space opacities in 90% of both lung fields with perihilar haze and blunting of the left cardiophrenic angle (Figure 1).
case_images: two-dimensional echocardiogram; a large left atrial mass is seen attached to the interatrial septum
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case_images: F2
case_images: Her 2-dimensional echocardiogram revealed a large left atrial mass attached to the interatrial septum, mitral regurgitation, and normal-sized ventricles with preserved ventricular function (Figure 2).
case_images: chest computed tomography (CT) scan; a left atrial mass is seen with an attachment to the interatrial septum
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case_images: F3
case_images: Tr) in the lumen of the left atrium attached to its anterior wall with a padding effect on the superior part of the left ventricle and aortic root (Figure 3, Figure 4).
case_images: computed tomography coronary angiography, normal angiogram; a minimally enhancing hypodense lesion is seen in the lumen of the left atrium
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case_images: F4
case_images: Tr) in the lumen of the left atrium attached to its anterior wall with a padding effect on the superior part of the left ventricle and aortic root (Figure 3, Figure 4). The main coronary branches showed a normal angiogram (Figure 4). The results of other investigations were normal.
case_images: the surgical findings; a large left atrial polypoid mass is seen with its stalk attached to the interatrial septum
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case_images: F5
case_images: Augmentin 1.2g stat, then 600mg 12 hourly, tabs Lisinopril 5mg once daily, tabs Bisoprolol 2.5mg once daily, tabs Rivaroxaban 15mg once daily, and tabs Rosuvastatin 10mg nocte. An open-heart surgery with excision of the left atrial mass (Figure 5) was done for the patient after informed consent was obtained from her.
case_images: gross pictures of the left atrial mass (A, B: gross pictures; C, D: serial sections of the mass)
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case_images: F6
case_images: Histologic sections of the mass show loose clusters of benign stellate-to-globular cells that have abundant eosinophilic cytoplasm, indistinct cell borders, oval nuclei with open chromatin and indistinct nucleoli, within a fibromyxoid stroma, consistent with an atrial myxoma (Figure 6, Figure 7).
case_images: histologic photomicrographs of the left atrial myxoma (hematoxylin and eosin staining, A: x 40 magnification; B: x 100 magnification)
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case_images: F7
case_images: Histologic sections of the mass show loose clusters of benign stellate-to-globular cells that have abundant eosinophilic cytoplasm, indistinct cell borders, oval nuclei with open chromatin and indistinct nucleoli, within a fibromyxoid stroma, consistent with an atrial myxoma (Figure 6, Figure 7).