Intramyocardial fat as a pathophysiological finding, in addition to the previously mentioned myocardial infarction, is connected to other conditions including arrhythmogenic right ventricular dysplasia, lipomatous hypertrophy
of the interatrial septum, dilative cardiomyopathy, cardiac lipoma, tuberous sclerosis complex, and muscular dystrophies (7).
The capsule is a major differentiation point between cardiac lipoma and lipomatous hypertrophy
. The latter is usually an asymptomatic continuation of the epicardial fat, and when arising from the interatrial septum, it usually spares the fossa ovalis .
Thoracoscopic relief of symptomatic lipomatous hypertrophy
of atrial septum.
Lipomatous hypertrophy of the atrial septum (LHAS) is a relatively uncommon benign abnormality characterized by accumulation of unencapsulated mass-forming mature fat within the atrial septum [1, 2].
Abbreviations LHAS: Lipomatous hypertrophy of the atrial septum TEE: Transesophageal echocardiography TTE: Transthoracic echocardiography LAD: Left anterior descending artery RCX: Ramus circumflex RCA: Right coronary artery RA: Right atrium.
To the Editor.--We read the outstanding article by Miller and Tazelaar1 recently published in the Archives of Pathology & Laboratory Medicine about the main features of 5 cardiovascular pseudoneoplasms (inflammatory myofibroblastic tumor, hamartoma of mature cardiac myocytes, mesothelial monocytic cardiac excrescences, calcified amorphous tumor, and lipomatous hypertrophy
of the atrial septum).
After those findings on TTE, we decided to perform a transesophageal echocardiography (TEE), which showed "dumbbell-shape" image, a very typical image for lipomatous hypertrophy (Fig.
Although lipomatous hypertrophy of interatrial septum has been known since 1960's, its pathophysiology is still unclear.
This section focuses on 5 reactive and "pseudoneoplastic" tumors of the heart, which mimic true neoplasms either grossly (including by clinical imaging) or microscopically, and include (1) inflammatory myofibroblastic tumor (IMT), (2) hamartoma of mature cardiac myocytes (HMCM), (3) mesothelial/monocytic incidental cardiac excrescences (MICE), (4) calcified amorphous tumor (CAT), and (5) lipomatous hypertrophy of the atrial septum (LHAS).
Lipomatous hypertrophy of the atrial septum, like CAT, is another lesion rarely mistaken for malignancy, histologically, but is of clinical significance owing to the frequent echocardiographic appearance of a mass protruding into the right atrium.
of the interatrial septum (LHAS), characterized with lipid deposition in the interatrial septum, is thought to be benign and rarely associated with clinical manifestations.
Pathologic examination of the specimen revealed the typical pattern of lipomatous hypertrophy
with large accumulation of adipose tissue (Fig.