Pathological Laughter Prodromal to a Stroke of the Head of the Left Caudate Nucleus

A 38-year-old right-handed female with a past history of intermittent painful rash, dizzy spells, and chronic daily headaches as well as episodic migraines experienced an episode of transient involuntary pathological laughter, right arm weakness, and expressive dysphasia. She was found on MRI to have multiple strokes in multiple vascular distributions, including one in the head of the left caudate. A cardiac ECHO found an atrial myxoma, with extensive evaluation for other causes of stroke unrevealing. The differential diagnosis for pathological laughter in this patient is discussed. The most plausible cause in this patient is an infarct to the head of the left caudate nucleus caused by an embolus of the atrial myxoma.

Right atrial myxoma as the first manifestation of granulomatosis with polyangiitis, and a possible association with vascular endothelial growth factor (VEGF) and interleukin 6 (IL-6): a case report and review of the literature

Background Granulomatosis with polyangiitis and myxomas are rare conditions previously described to co-exist. Cardiac masses are often presumed to be myxomas rather than lesions of granulomatosis with polyangiitis. Case presentation We present a review of the symptoms for the two diagnoses along with the first verified case. Conclusions Two possible risk factors for developing myxomas (VEGF and IL-6) are explored and discussed.

Left Atrial Myxoma and Antiphospholipid Syndrome—A Case Report

Cardiac myxoma (CM) is the most frequent type of primary cardiac neoplasm and is responsible for 58 to 80% of primary cardiac tumors. The antiphospholipid syndrome (APS) occurs most commonly in the systemic lupus erythematosus but it can be also found in other conditions. The coexistence of CM and APS is rarely described in the literature. We report an unusual case of the left atrial myxoma and concomitant APS in a female patient who presented with right-sided hemiplegia. Although rare, we must think about the CM in patients with a newly diagnosed APS and left atrial mass. Nevertheless, we must make a distinction from other possible cardiac structures, especially atrial thrombus. Transthoracic echocardiography is the most frequently used initial imaging modality to detect CM. The aim of this case report was to emphasize that additional imaging modalities and multidisciplinary approach are mandatory in making a proper diagnosis and to choose a further treatment strategy.

Mediastinal Non-Hodgkin's Lymphoma Metastatic to Right Atrium Mimicking Right Atrial Myxoma

Highlight:A 32-year-old male patient suffered mediastinal non-hodgkin's lymphoma metastatic to the right atrium which mimicked right atrial myxoma.The patient died of suspected mediastinal NHL thromboembolism that spread in the right atrium. Abstract:In this case report, the anatomical pathology results in the form of B cell type LNH, but at the age of 32 years and the risk factor in this patient was a former active smoker. In the anatomical pathology results, the results of the B-High Grade Cell Type LNH were also obtained. B-cell type non-hodgkin’s lymphoma can be mutated in the MYC gene (v-myc avian myceloctomatosis viral oncogene homolog) and the BCL-2 and BCL-6 (B-cell lymphoma) genes. If this morphology is found, then the patient's prognosis is poor. Most of these patients were males and the incidence was in the mediastinal area. Mediastinal NHL could develop and enlarge to involve the heart and pericardium. The spread could occur directly and lymphogens. These metastatic tumors were often misdiagnosed with atrial myxoma. In this case report, exploration of the right atrium and open mediastinal biopsy was performed. An open biopsy of the mediastinum revealed a mediastinal mass that enlarged to enter the right atrium. Atrial myxoma was not found. Primary lymphoma growth could also occur in the heart. This condition was called primary cardiac lymphoid (PCL). This case was very rare and was often considered an atrial myxoma. The patient died 10 days after discharge from the hospital. While the patient was eating, the patient had a seizure and the patient was immediately taken to the emergency department of Dr. Soetomo General Academic Hospital, Surabaya, and entered the ER (Resuscitation) ER room, but the patient died after being assisted for approximately two hours. Most likely the cause of the patient's death was a thromboembolic tumor in the right atrium that was released, so that it entered the bloodstream of the brain, causing the patient to have seizures. It was suspected that the cause of the patient's death was the presence of a tumor thrombus that separated into an embolism from the right atrium due to the large size of the tumor. Patients suffering from high rate NHL had a greater percentage of suffering from tumor thromboembolism as many as 10.6% compared to the Low type and Hodgkins lymphoma (LH) (5.8% and 7.25%).