Calretinin as a Marker for Cardiac Myxoma

Abstract

To study the usefulness of calretinin as an immunohistochemistry marker in the diagnosis of cardiac myxoma (CM) and the origin of myxoma cells, we examined 24 CMs and 9 fetal hearts with immunohistochemical methods on formalin-fixed paraffin-embedded tissues. We compared 24 CMs with 10 mural thrombi, 6 jaw myxomas, and 2 papillary fibroelastomas. Calretinin expression was identified in 100% of CMs and was negative in all cases of mural thrombi, jaw myxoma, and papillary fibroelastoma. Calretinin expression by the neoplastic cells in CM was strong and diffuse and had a cytoplasmic and a nuclear pattern. Calretinin expression in fetal hearts was found in autonomic ganglia cells in the subepicardial tissue of the atria and atrial appendages, along the interatrial and atrioventricular sulci, and in the atrial septum. Results clearly indicate that calretinin can be used as a marker for the diagnosis of CM and that it is a powerful tool for the differential diagnosis, most importantly with mural myxoid thrombi. Furthermore, the positive expression of calretinin by the autonomic neurons in the fetal heart and CM supports the concept that myxoma cells may originate from endocardial sensory nerve tissue.

Cardiac myxoma the great imitators: Comprehensive histopathological and molecular approach

“…Neuroendocrine origin of CMs was further supported with findings of Teraccianno et all [140]. They detected strong and diffuse immunohistochemical staining of CALB2 (calretinin/calbindin 2 protein normally detected in the cells of the central and peripheral neural tissue) in the cytoplasm and nucleus of neoplastic cells of all examined (n=24) sporadic CM cases [141].…”

Detection of Herplex Simplex Virus-1 and -2 in Cardiac Myxomas

“…The myxoma was excised from the right atrium in 22 patients (75.9%) from the left atrium in 2 patients (6.9%), while in 5 (17.2%) patients the lesion was excised from the right ventricle. Histological evaluation clearly exhibited the characteristic gel-like stroma of mucopolysaccharides on hematoxylin-eosin (H&E) staining (Figure 1(a)) [13]. In this cohort of specimens, 17/29 cases produced appropriate DNA yields for further HSV detection.…”

Expression and diagnostic values of calretinin and CK5/6 in cholangiocarcinoma

“…Since it was found expressed in mesothelioma in 1990s [34], many types of tumor and tissue are found immunocreactive to calretinin including 22.5% of examined colonic carcinomas [35], 81.5% of ameloblastomas [36], 36% of thymic carcinomas [10], 100% of cardiac myxomas [37], 56-100% sex cord-stromal and 90-100% fibrous neoplasms of the ovaries [38-40], 95% olfactory neuroblastoma [41], 95% of adrenal cortical tumors [42], 71% of synovial sarcomas [43], 15% breast carcinomas [44], skin [45] and others [46]. Our study indicates that CC may be calretinin positive regardless of CC grade and location, and should be considered in the differential diagnoses for calretinin positive tumor.…”