CTICasesRight Atrial Myxoma with Pulmonary Embolism and Hemorrhage
Imaging findings
A CT scan shows pulmonary emboli, lung infarcts, and hemorrhage. A filling defect with frond-like morphology is identified in the right atrium, which is more convincing for a true mass on coronal views, rather than flow artifact. Cardiac MRI (SSFP and perfusion images) confirms the mass in the right atrium, with fronds, and is seen traversing the tricuspid valve. The lung findings likely represent macroscopic thrombi originating from the tumor and effects of myxoid tissue causing vascular insult and hemorrhage.
Key takeaways
Right atrial myxomas can embolize to the pulmonary arteries, leading to pulmonary embolism, infarcts, and hemorrhage. The characteristic frond-like appearance of myxomas on imaging is a key diagnostic clue. When pulmonary emboli are identified, especially if recurrent or with atypical features, careful evaluation of the heart for an intracardiac source such as a myxoma is warranted.
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