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Questions and Answers
What is a common site for angiosarcomas?
What is a common site for angiosarcomas?
Which of the following best describes the clinical pattern of angiosarcomas?
Which of the following best describes the clinical pattern of angiosarcomas?
What is the primary characteristic of angiosarcomas under microscopic examination?
What is the primary characteristic of angiosarcomas under microscopic examination?
What factor is typically associated with the development of lymphangiosarcoma following surgery?
What factor is typically associated with the development of lymphangiosarcoma following surgery?
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What is the usual age group affected by angiosarcomas?
What is the usual age group affected by angiosarcomas?
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Which primary cardiac tumor is most frequently found in adults?
Which primary cardiac tumor is most frequently found in adults?
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What percentage of primary heart tumors do the five common types account for?
What percentage of primary heart tumors do the five common types account for?
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Where do most cardiac myxomas arise in the heart?
Where do most cardiac myxomas arise in the heart?
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What is the most common primary malignant tumor of the heart?
What is the most common primary malignant tumor of the heart?
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What characterizes cavernous hemangiomas compared to capillary hemangiomas?
What characterizes cavernous hemangiomas compared to capillary hemangiomas?
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Which type of tumor is associated with tuberous sclerosis in children?
Which type of tumor is associated with tuberous sclerosis in children?
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What is a common feature of brain hemangiomas?
What is a common feature of brain hemangiomas?
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What is a common clinical manifestation of cardiac myxomas?
What is a common clinical manifestation of cardiac myxomas?
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What is the appearance of myxomas when examined grossly?
What is the appearance of myxomas when examined grossly?
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Which statement is true regarding simple (capillary) lymphangiomas?
Which statement is true regarding simple (capillary) lymphangiomas?
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What is the almost uniform treatment for cardiac myxomas?
What is the almost uniform treatment for cardiac myxomas?
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What distinguishes cavernous lymphangiomas from other types?
What distinguishes cavernous lymphangiomas from other types?
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What is the primary virus associated with Kaposi sarcoma?
What is the primary virus associated with Kaposi sarcoma?
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What is the typical clinical significance of cavernous hemangiomas?
What is the typical clinical significance of cavernous hemangiomas?
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Where do simple (capillary) lymphangiomas primarily occur?
Where do simple (capillary) lymphangiomas primarily occur?
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What feature is NOT commonly associated with cavernous hemangiomas?
What feature is NOT commonly associated with cavernous hemangiomas?
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What is the appearance of lesions during the patch stage of classic Kaposi sarcoma?
What is the appearance of lesions during the patch stage of classic Kaposi sarcoma?
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What type of cells are primarily found in the plaque stage lesions?
What type of cells are primarily found in the plaque stage lesions?
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Which characteristic is common to the nodular stage of classic Kaposi sarcoma?
Which characteristic is common to the nodular stage of classic Kaposi sarcoma?
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Where are the lesions primarily located during the plaque stage?
Where are the lesions primarily located during the plaque stage?
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What are ‘spider cells’ primarily characterized by?
What are ‘spider cells’ primarily characterized by?
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What additional features are more pronounced during the plaque stage?
What additional features are more pronounced during the plaque stage?
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Which type of tumor is most commonly associated with the pericardium?
Which type of tumor is most commonly associated with the pericardium?
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What distinct cell type is commonly associated with the nodule stage lesions?
What distinct cell type is commonly associated with the nodule stage lesions?
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Which statement about benign tumors is accurate?
Which statement about benign tumors is accurate?
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What is a typical challenge when diagnosing the patch stage lesions?
What is a typical challenge when diagnosing the patch stage lesions?
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What characterizes hemangiomas?
What characterizes hemangiomas?
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Which of the following best describes the blood vessels during the patch stage?
Which of the following best describes the blood vessels during the patch stage?
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What is the typical growth pattern of juvenile hemangiomas?
What is the typical growth pattern of juvenile hemangiomas?
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How can cardiac metastases occur?
How can cardiac metastases occur?
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Which is the most common vascular tumor of the head and neck in infants?
Which is the most common vascular tumor of the head and neck in infants?
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What is the most common site for internal hemangiomas?
What is the most common site for internal hemangiomas?
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What is the typical appearance of advanced angiosarcoma lesions?
What is the typical appearance of advanced angiosarcoma lesions?
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Which type of cardiac tumor is primarily associated with infants and children?
Which type of cardiac tumor is primarily associated with infants and children?
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Which microscopic characteristic can help identify poorly differentiated angiosarcoma tumors?
Which microscopic characteristic can help identify poorly differentiated angiosarcoma tumors?
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What percentage of all primary heart tumors do the five most common benign types account for?
What percentage of all primary heart tumors do the five most common benign types account for?
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Where do most myxomas in adults commonly arise in the heart?
Where do most myxomas in adults commonly arise in the heart?
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What condition often precedes the development of lymphangiosarcoma in patients?
What condition often precedes the development of lymphangiosarcoma in patients?
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Which age group is most commonly affected by angiosarcomas?
Which age group is most commonly affected by angiosarcomas?
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What is the primary method of treatment for cardiac myxomas?
What is the primary method of treatment for cardiac myxomas?
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What is a common clinical feature associated with advanced angiosarcomas?
What is a common clinical feature associated with advanced angiosarcomas?
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Which of the following is a characteristic appearance of myxomas when examined grossly?
Which of the following is a characteristic appearance of myxomas when examined grossly?
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What is a common clinical manifestation of cardiac myxomas?
What is a common clinical manifestation of cardiac myxomas?
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Fibromas constitute which ranking of the most common types of primary cardiac tumors?
Fibromas constitute which ranking of the most common types of primary cardiac tumors?
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Which primary malignant tumor is most commonly found in the heart?
Which primary malignant tumor is most commonly found in the heart?
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What is the primary characteristic of lesions during the patch stage of classic Kaposi sarcoma?
What is the primary characteristic of lesions during the patch stage of classic Kaposi sarcoma?
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Which feature is commonly associated with the plaque stage of classic Kaposi sarcoma?
Which feature is commonly associated with the plaque stage of classic Kaposi sarcoma?
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What distinguishes the nodular stage lesions of classic Kaposi sarcoma from those in the earlier stages?
What distinguishes the nodular stage lesions of classic Kaposi sarcoma from those in the earlier stages?
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In the plaque stage of classic Kaposi sarcoma, what type of cells are commonly found?
In the plaque stage of classic Kaposi sarcoma, what type of cells are commonly found?
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What is the primary structural characteristic of 'spider cells' found in teratomas?
What is the primary structural characteristic of 'spider cells' found in teratomas?
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Which characteristic is NOT associated with the biopsy findings of the patch stage lesions in classic Kaposi sarcoma?
Which characteristic is NOT associated with the biopsy findings of the patch stage lesions in classic Kaposi sarcoma?
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What is the incidence of benign tumors like hemangiomas in infants?
What is the incidence of benign tumors like hemangiomas in infants?
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During the nodule stage of classic Kaposi sarcoma, which component is typically present?
During the nodule stage of classic Kaposi sarcoma, which component is typically present?
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What is a notable challenge in distinguishing patch stage lesions from other skin conditions?
What is a notable challenge in distinguishing patch stage lesions from other skin conditions?
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How are cardiac metastases most commonly disseminated to the heart?
How are cardiac metastases most commonly disseminated to the heart?
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What is a distinguishing feature of malignant tumors compared to benign tumors?
What is a distinguishing feature of malignant tumors compared to benign tumors?
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Which feature is prominent in the plaque stage of classic Kaposi sarcoma compared to the patch stage?
Which feature is prominent in the plaque stage of classic Kaposi sarcoma compared to the patch stage?
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Which type of hemangiomas is extremely common in newborns and often fades after several years?
Which type of hemangiomas is extremely common in newborns and often fades after several years?
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What factors can contribute to the clinical presentation of hemangiomas?
What factors can contribute to the clinical presentation of hemangiomas?
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What is a common characteristic of capillary hemangiomas under microscopic examination?
What is a common characteristic of capillary hemangiomas under microscopic examination?
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Which statement about the growth patterns of hemangiomas is accurate?
Which statement about the growth patterns of hemangiomas is accurate?
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What distinguishes cavernous hemangiomas from capillary hemangiomas?
What distinguishes cavernous hemangiomas from capillary hemangiomas?
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Which of the following best describes the histologic appearance of cavernous hemangiomas?
Which of the following best describes the histologic appearance of cavernous hemangiomas?
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What is a notable clinical concern regarding brain hemangiomas?
What is a notable clinical concern regarding brain hemangiomas?
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What is the significance of the unencapsulated nature of cavernous lymphangiomas?
What is the significance of the unencapsulated nature of cavernous lymphangiomas?
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Which of the following correctly describes the structure of simple (capillary) lymphangiomas?
Which of the following correctly describes the structure of simple (capillary) lymphangiomas?
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What is a primary characteristic of cavernous lymphangiomas?
What is a primary characteristic of cavernous lymphangiomas?
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Which virus is predominantly associated with Kaposi sarcoma in patients?
Which virus is predominantly associated with Kaposi sarcoma in patients?
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What is a common complication of cavernous hemangiomas?
What is a common complication of cavernous hemangiomas?
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Study Notes
Cardiac Tumors
- Primary cardiac tumors are rare and mostly benign.
- The most common benign cardiac tumors are myxomas, fibromas, lipomas, papillary fibroelastomas, and rhabdomyomas, accounting for 80-90% of all primary heart tumors.
- Myxomas are the most frequent in adults, usually located in the left atrium.
- Myxomas are composed of stellate cells embedded in an acid mucopolysaccharide ground substance.
- Rhabdomyomas are the most common primary cardiac tumors in infants and children, frequently associated with tuberous sclerosis.
- Rhabdomyomas appear as gray-white masses, characterized by large, rounded, or polygonal cells containing glycogen-laden vacuoles.
- Cardiac metastases can occur by direct extension, bloodstream, lymphatics, and intracavitary diffusion.
- Pericardial metastasis is the most common.
Pericardial Diseases
- Hemangiomas are benign tumors composed of vascular channels filled with blood cells or lymph.
- They are the most common vascular tumor of the head and neck in infancy.
- Hemangiomas are typically present from birth and may eventually regress spontaneously.
- Lymphangiomas are benign lymphatic counterparts of hemangiomas, occurring predominantly in head, neck, and axillary subcutaneous tissues.
- Kaposi sarcoma, frequently observed in HIV patients, is a malignant endothelial neoplasm associated with Kaposi sarcoma herpesvirus (KSHV).
- Kaposi sarcoma lesions progress through three stages: patch, plaque, and nodule.
- Angiosarcoma is a malignant endothelial neoplasm of variable differentiation, ranging from well-differentiated tumors resembling hemangiomas to highly aggressive lesions.
- Angiosarcoma predominantly affects older adults and can occur at any site, with a predilection for skin, soft tissue, breast, and liver.
Pericardial Diseases - Causes
- Pericardial diseases can be caused by a variety of factors, including trauma, drugs, heart tumors, systemic lupus erythematosus (SLE), uremia, radiotherapy, and hypothyroidism.
Cardiac Myxoma
- Most common primary tumor of the adult heart.
- 90% are atrial, 80% of those are in the left atrium.
- Usually single.
- Commonly found in the fossa ovalis (atrial septum).
- Can be sessile or pedunculated.
- Appears soft, translucent, villous, gelatinous.
- Consists of multinucleated stellate cells embedded in an abundant acid mucopolysaccharide ground substance.
- Clinically manifests as a "ball-valve" obstruction of the valves, embolization, or constitutional symptoms such as fever and malaise.
- Surgical resection is curative in nearly all cases.
Rhabdomyomas
- Most common primary heart tumor in infants and children.
- Frequently discovered due to valvular or outflow obstruction.
- Commonly found in patients with tuberous sclerosis.
- Appear as gray-white masses up to several centimeters, protruding into ventricular chambers.
- Characterized by large, rounded, or polygonal cells with numerous glycogen-laden vacuoles, separated by strands of cytoplasm running from the cell membrane to the nucleus, known as 'spider cells'.
Teratomas
- Second most common cardiac tumor in infants.
- Typically arise from the pericardium.
- Usually benign.
- Rarely recur.
Cardiac Metastasis
- Can occur through:
- Direct extension.
- Bloodstream.
- Lymphatics.
- Intracavitary diffusion.
- Pericardial metastasis is the most common.
Hemangiomas
- Benign vascular tumor.
- Common in infants and childhood.
- Often regresses spontaneously.
- Occurs in the head and neck, but can be more extensive (angiomatosis) and found internally.
- 1/3 of internal lesions are found in the liver.
- Types:
- Capillary hemangiomas: most common, composed of thin-walled capillaries with minimal stroma.
- Juvenile hemangiomas: extremely common in newborns, often multiple, grow rapidly for a few months then fade by 1-3 years, completely regress by 7 years in most cases.
- Cavernous hemangiomas: large, dilated vascular channels, more infiltrative, frequently involve deep structures, don't spontaneously regress.
Lymphangiomas
- Benign lymphatic counterpart of hemangiomas.
- Types:
- Simple lymphangiomas: slightly elevated, up to 1-2 cm in diameter, common in the head, neck, and axillary subcutaneous tissue, composed of networks of endothelium-lined spaces.
- Cavernous lymphangiomas (cystic hygromas): fluid-filled sac in the neck or axilla of infants, large (up to 15 cm), composed of massively dilated lymphatic spaces lined by endothelial cells and separated by connective tissue stroma containing lymphoid aggregates.
Kaposi Sarcoma
- Caused by Kaposi sarcoma herpesvirus (KSHV, or HHV-8).
- Common in HIV patients.
- Progresses through three stages:
- Patch stage: pink, red, or purple macules, confined to distal lower extremities.
- Plaque stage: larger violaceous patches, raised plaques.
- Nodular stage: accompanied by nodal and visceral involvement, plump proliferating spindle cells in the dermis or subcutaneous tissues.
Angiosarcoma
- Malignant endothelial neoplasms.
- Range from highly differentiated to anaplastic.
- Most common in older adults.
- No sex predilection.
- Lesions occur anywhere, most common in skin, soft tissue, breast, and liver.
- Aggressive, invasive, and metastasizes.
- Can arise in the setting of lymphedema, classically after radical mastectomy.
- Begins as small, asymptomatic red nodules, developing into fleshy, red-tan to gray-white masses, blending with surrounding structures.
- Necrosis and hemorrhage are common.
Pericarditis Causes
- Trauma.
- Drugs.
- Heart tumors.
- Systemic lupus erythematosus (SLE).
- Uremia.
- Radiotherapy.
- Hypothyroidism.
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