Neurology
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M. Tondelli, MD, J. Mandrioli, MD, G. Ficarra, MD, R. Pentore, MD, F. Girolami, MD, I. Ghidoni, MD and V. Agnoletto, MD

From the Neurology Clinic (M.T., J.M., R.P., F.G.), Department of Neuroscience, and Department of Pathologic Anatomy and Legal Medicine (G.F.), Section of Pathologic Anatomy, University of Modena and Reggio Emilia, Modena, Italy; Divisions of Cardiovascular Surgery (I.G.), Hesperia Hospital, Modena; and Cardiology Division (V.A.), St. Agostino-Estense Hospital, Modena.


Figure 118
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  		Figure 1 Preoperative evaluation findings

(A) Axial FLAIR T2-weighted MRI: left frontal opercular infarction (arrow). (B) Transcranial color-coded duplex sonography: right-to-left shunt (RLSh) with shower of bubbles (>25 high intensity transient signals). (C) Transesophageal echocardiography: patent foramen ovale (PFO) (arrow) and myxoma (4.2 x 2.4 cm) (arrowheads) protruding on RLSh. (D) Coronary angiography showing myxoma supplied by distal circumflex artery.

 

Figure 218
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  		Figure 2 Postoperative findings after myxoma resection

(A) Macroscopic image of myxoma, showing highly irregular, multilobulated appearance. (B) Histologic slide of the myxoma, showing stellate cells (arrow), vascular structures (arrowheads), and myxoid ground substance (hematoxylin-eosin stain).

 




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