Lipomatous hypertrophy of the interatrial septum is a pathologic, not an anatomic diagnosis

J Card Surg. 2020 May;35(5):1132-1134. doi: 10.1111/jocs.14528. Epub 2020 Apr 1.

Abstract

Background and aim: Lipomatous hypertrophy of the interatrial septum (LHIS), a fatty tumor, is usually diagnosed on both echo and CT/MRI imaging. Cases of LHIS located outside of the interatrial septum are extremely rare and rarer still are these cases large enough to cause symptoms. The clinical literature demonstrates a misunderstanding that fatty tumors outside the intra-atrial area represent lipomas. However, pathologic understanding of these fatty tumors is clear and is based on microscopic findings.

Methods: The tumor was removed by diving the base of attachment at the left ventricular apex via a median sternotomy on cardiopulmonary bypass.

Results: The patient made an uneventful recovery and remains well at 6 months postoperatively.

Conclusions: On rare occasions, LHIS can arise from outside the interatrial septum. An LHIS can be differentiated from a lipoma by the presence of entrapped cardiac myocytes in LHIS, making it a pathological, rather than an anatomic, diagnosis.

Keywords: anatomy; cardiac tumors; cardiovascular pathology; pathology; tumor biology.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Atrial Septum / pathology*
  • Cardiac Surgical Procedures
  • Cardiopulmonary Bypass
  • Heart Atria / pathology*
  • Heart Neoplasms / diagnosis*
  • Heart Neoplasms / pathology*
  • Heart Neoplasms / surgery
  • Heart Septum / pathology*
  • Humans
  • Hypertrophy
  • Lipoma / diagnosis*
  • Lipoma / pathology*
  • Lipoma / surgery
  • Magnetic Resonance Imaging
  • Male
  • Sternotomy
  • Tomography, X-Ray Computed
  • Treatment Outcome