Cardiac and Vascular Masses Flashcards Preview

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Flashcards in Cardiac and Vascular Masses Deck (36):
1

What is thrombosis?

Formation of a blood clot within intact vessels

2

What are lines of Zahn?

Laminations apparent grossly or microscopically - produced by alternating layers of platelets, fibrin, and RBCs

3

What is Virchow's Triad in thrombosis?

  1. Endothelial Injury
  2. Abnormal Blood Flow
  3. Hypercoagulability

4

What are examples of abnormal blood flow that can lead to cardiac thrombi?

  • Arrhythmia
  • Dilated Cardiomyopathy
  • Myocardial infarction

5

What is the clinical significance of a thrombus in the left atrium or ventricle?

  • Embolization to various organs
  • Decreased cardiac output

6

What is the clinical significance of a thrombus in the right atrium or right ventricle?

  • Embolization to lungs
  • Decreased cardiac output

7

Define an Embolus

Detached intravascular mass carried by blood to site distant from origin

8

What are different types of emboli?

  • Thrombus (most common)
  • Fat
  • Air
  • Amniotic fluid
  • Tumor

9

Systemic embolism origins

Heart: Atrium, ventricle, valve (80%)

Atherosclerotic plaque (abdominal aorta, carotid artery)

10

What are the common destinations of an embolus?

Lower legs (75%)

Brain (10%)

11

What is a paradoxical embolism?

An embolus that travels through a heart defect into systemic circulation

12

What are the most common tumors found in the heart?

Metastatic tumors

13

What is the most common cardiac tumor (originating in the heart)

Myxoma

14

How do myxomas present?

Sessile or pedunculated (ball valve obstruction)

Myxoma cells embedded in abundant ground substance

15

What is Carney syndrome

A clinical manifestation found in 10% of myxomas

  • Multiple cardiac myxomas, spotty pigmentation, endocrine overactivity
  • Familial (Autosomal dominant and recessive)

16

What is the most common heart tumor in infants/children?

Rhabdomyoma

17

What complication is rhabdomyoma associated with?

Associated with tuberous sclerosis

18

What is the morphology of a rhabdomyoma?

Gross:

Histology:

Gross: Usually multiple, firm white nodules

Histology: Spider cells

 

A image thumb
19

What are the less common primary neoplasms?

Lipomas - often asymptomatic, may cause ball-valve effect or arrhythmias

Papillary fibroelsatomas - form on valves, can embolize

Angiosarcomas

20

What are the benign vascular malformations (neoplasms)?

Hemangioma

Lymphangioma

Glomus tumor

Bacillary angiomatosis

21

What are the intermediate grade vascular malformations?

Kaposi sarcoma

Hemangioendothelioma

 

22

What are the malignant vascular malformations?

Angiosarcoma

Hemangiopericytoma

23

What are the presentations of the capillary hemangiomas?

Juvenile "strawberry" hemangioma - grows for a few months, fade around 2yo and regresses by age 7

Adult "cherry" hemangioma - Does not regress

Pyogenic granulomas - Ulcerate and bleed, seen with pregnancy or trauma

24

What are cavernous hemangiomas

Larger, dilated channels in deeper tissue that do not regress

Associated with von Hippel Lindau disease

25

How are hemangiomas classified?

Based on vessel size

Capillary vs cavernous type

26

What are the different types of lymphangiomas?

Simple lymphangiomas - small, head/neck/axilla

  • Cavernous lymphangiomas
    • neck/axilla of infants or children
    • poorly circumscribed
    • Associated with turner syndrome

27

Describe a glomus tumor (glomangioma)

Composed of clomus cells

Small, on digits, often under nails

Painful, easily cured by exision

28

What benign vascular lesion is associated with a Bartonella infection (secrete HIF-1) in immunocompromised hosts?

Bacillary angiomatosis

29

Kaposi Sarcoma Presentations?

  1. Chronic, classic: indolent
  2. Lymphadenopathic, African or endemic
  3. Transplant - associated KS
  4. AIDS - associated KS

30

What virus is found in 95% of KS pathogenisis?

Human Herpes Virus type 8

31

KS disease expression is affected by degree of _________

immunosuppression

32

What type of cells are seen in later stages of KS morphology?

Spindle cells

33

Treatment or KS?

  • Resection/cryotherapy
  • Radiation
  • Chemotherapy

34

What malignant neoplasm of endothelial cells  is found in older adults?

Angiosarcoma

35

What are specific associations with angiosarcoma?

Liver and arsenic, throtrast, polyvinyl choloride

Arm in patient with lymphedema, most commonly , post mastectomy

Post radiation

36

Lymphangiosarcoma is a malignant variation of _________

lymphangioma