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Best Cases from the AFIP

Cardiac Angiosarcoma¹

¹ From the Queen Elizabeth II Health Sciences Centre, 1278 Tower Rd, Victoria General Site, Halifax, Nova Scotia, Canada, B3H 2Y9. Received June 4, 2003; revision requested July 1 and received July 23; accepted July 28. Address correspondence to A.B. (e-mail: abest@is2.dal.ca).

View larger version (100K): [in a new window]   Figure 1a.  Cardiac angiosarcoma. (a) Axial contrast-enhanced CT scan shows a low-attenuation, lobulated right atrial mass (arrow). (b) Axial T1-weighted MR image obtained with gadolinium shows nodular enhancement of the right atrial mass (arrow). (c) Coronal T1-weighted MR image obtained without gadolinium shows the mass (arrow) arising from the free wall of the right atrium. The mass is slightly hyperintense relative to myocardium. (d) Right coronary angiogram shows tumor blush (arrow).

View larger version (108K): [in a new window]   Figure 1b.  Cardiac angiosarcoma. (a) Axial contrast-enhanced CT scan shows a low-attenuation, lobulated right atrial mass (arrow). (b) Axial T1-weighted MR image obtained with gadolinium shows nodular enhancement of the right atrial mass (arrow). (c) Coronal T1-weighted MR image obtained without gadolinium shows the mass (arrow) arising from the free wall of the right atrium. The mass is slightly hyperintense relative to myocardium. (d) Right coronary angiogram shows tumor blush (arrow).

View larger version (116K): [in a new window]   Figure 1c.  Cardiac angiosarcoma. (a) Axial contrast-enhanced CT scan shows a low-attenuation, lobulated right atrial mass (arrow). (b) Axial T1-weighted MR image obtained with gadolinium shows nodular enhancement of the right atrial mass (arrow). (c) Coronal T1-weighted MR image obtained without gadolinium shows the mass (arrow) arising from the free wall of the right atrium. The mass is slightly hyperintense relative to myocardium. (d) Right coronary angiogram shows tumor blush (arrow).

View larger version (122K): [in a new window]   Figure 1d.  Cardiac angiosarcoma. (a) Axial contrast-enhanced CT scan shows a low-attenuation, lobulated right atrial mass (arrow). (b) Axial T1-weighted MR image obtained with gadolinium shows nodular enhancement of the right atrial mass (arrow). (c) Coronal T1-weighted MR image obtained without gadolinium shows the mass (arrow) arising from the free wall of the right atrium. The mass is slightly hyperintense relative to myocardium. (d) Right coronary angiogram shows tumor blush (arrow).

View larger version (119K): [in a new window]   Figure 2a.  Cardiac angiosarcoma. (a) Photograph of the resected specimen shows a portion of the right atrium and intraatrial tumor. Arising from the free wall of the right atrium, the angiosarcoma shows frondlike papillary projections (arrow). (b) Photograph of the bisected angiosarcoma shows areas of hemorrhage and necrosis (arrow).

View larger version (118K): [in a new window]   Figure 2b.  Cardiac angiosarcoma. (a) Photograph of the resected specimen shows a portion of the right atrium and intraatrial tumor. Arising from the free wall of the right atrium, the angiosarcoma shows frondlike papillary projections (arrow). (b) Photograph of the bisected angiosarcoma shows areas of hemorrhage and necrosis (arrow).

View larger version (89K): [in a new window]   Figure 3a.  Cardiac angiosarcoma. (a) Photomicrograph (original magnification, x4; hematoxylin-eosin stain) shows frondlike projections (arrow) arising from the luminal surface of the angiosarcoma. In this particular section, the right atrial wall is completely replaced by tumor, necrosis, and hemorrhage. (b) Low-power photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows the angiosarcoma (arrows) invading normal right atrial myocardium. (c) Photomicrograph (original magnification, x100, hematoxylin-eosin stain) shows red blood cells clustered together within a vascular channel (arrow) lined with atypical endothelial cells. This appearance is characteristic for angiosarcoma.

View larger version (168K): [in a new window]   Figure 3b.  Cardiac angiosarcoma. (a) Photomicrograph (original magnification, x4; hematoxylin-eosin stain) shows frondlike projections (arrow) arising from the luminal surface of the angiosarcoma. In this particular section, the right atrial wall is completely replaced by tumor, necrosis, and hemorrhage. (b) Low-power photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows the angiosarcoma (arrows) invading normal right atrial myocardium. (c) Photomicrograph (original magnification, x100, hematoxylin-eosin stain) shows red blood cells clustered together within a vascular channel (arrow) lined with atypical endothelial cells. This appearance is characteristic for angiosarcoma.

View larger version (168K): [in a new window]   Figure 3c.  Cardiac angiosarcoma. (a) Photomicrograph (original magnification, x4; hematoxylin-eosin stain) shows frondlike projections (arrow) arising from the luminal surface of the angiosarcoma. In this particular section, the right atrial wall is completely replaced by tumor, necrosis, and hemorrhage. (b) Low-power photomicrograph (original magnification, x40; hematoxylin-eosin stain) shows the angiosarcoma (arrows) invading normal right atrial myocardium. (c) Photomicrograph (original magnification, x100, hematoxylin-eosin stain) shows red blood cells clustered together within a vascular channel (arrow) lined with atypical endothelial cells. This appearance is characteristic for angiosarcoma.