Cardiac tumors laboratory tests

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Template:Dj

Biopsy is required for definitive diagnosis, echocardiogram is a preliminary diagnosing tool for most cardiac tumors. Certain cardiac tumors release inflammatory cytokines which can lead to increased blood inflammatory markers like ESR, CRP.

• Some patients with cardiac tumors may have anemia, less commonly thrombocytopenia, increases in sedimentation rate, serum C-reactive protein level, or globulin level. These are nonspecific diagnostic anomalies.^[1][2]
• Antimyolemmal antibodies could also be elevated. Antimyolemmal antibodies are significantly more prevalent in chronic pericardial effusion, perimyocarditis, and dilated cardiomyopathy patients than healthy controls.^[3]
• Antiendothelial antibodies of the IgG type are detected in 86 percent of atrial myxoma patients. Endothelial cells are activated by Antiendothelial antibodies, leading to enhanced leukocyte adhesion, clotting activation, and vessel thrombosis.^[4][3]

• The CXR can detect cardiomegaly. A localized tumor prominence may or may not be present.
• On echocardiography, a massive, noncontractile, firm lump may be observed in the atrial or ventricular walls. It is more useful in diagnosing myxomas as compared to sarcomas.^[5]
• Doppler ultrasonography measures of velocities can be used to calculate chamber pressures.^[6]
• Transesophageal echocardiography (TEE) is appropriate for evaluating malignancies anticipated to include the atria, interatrial septum, superior vena cava, atrioventricular valves, and, to a minor degree, the ventricles.^[5]
• CT and Cardiac MRI(CMR)are helpful for resectability evaluation.^[5]
• PET can be utilized to detect cardiovascular spread in patients with metastatic malignancies and enables surgical treatment.^[7]
  • Imaging tests individually cannot determine if a heart tumor is benign or malignant; histologic assessment is required for a definite diagnosis.

• Biopsy provides the definitive diagnosis and can be performed either as a:
• Minimally invasive techniques such as
  • cytologic assessment of pericardial/pleural fluids,
  • echo-guided percutaneous cardiac biopsy, and
  • echo-guided transvenous cardiac biopsy can be used to diagnose tissue.
• Or, mediastinoscopy or thoracotomy for more invasive tumor biopsies for a definitive diagnosis.^[8]
• The false-negative rate of Minimally Invasive techniques can be substantially high.^[8]

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