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. 2018 Jan;24(1):47-53.
doi: 10.1177/1753425917741678. Epub 2017 Nov 16.

Innate immunity in cardiac myxomas and its pathological and clinical correlations

Anna Di Vito  1 , Gianluca Santise  2 , Chiara Mignogna  3 , Eusebio Chiefari  3 , Gabriella Cardillo  3 , Ivan Presta  3 , Franco Arturi  4 , Natalia Malara  1 , Francesco Brunetti  5 , Annalidia Donato  4 , Domenico Maisano  6 , Stefania Leonetti  7 , Daniele Maselli  2 , Tullio Barni  1 , Giuseppe Donato  3
Affiliations

Innate immunity in cardiac myxomas and its pathological and clinical correlations

Anna Di Vito et al. Innate Immun. 2018 Jan.

Abstract

Cardiac myxomas are the most common benign cardiac tumor. We investigated the immunohistochemical properties of 11 surgically excised cardiac myxomas, in order to analyze the correlation between macrophages and mast cell populations and clinical parameters. CD68+/CD163-/iNOS- (M0) cells represent the most abundant macrophage phenotype; however, CD68+/CD163+ cells (M2) were also frequent. CD68+/iNOS+ (M1) elements were rare. Mast cells, defined as a population of c-kit (CD117)+ and/or tryptase+ cells were also detected. Statistical analysis showed significant correlations between c-kit (CD117)+ and tryptase, CD68 and erythrocyte sedimentation rate (ESR), ESR and red blood cell count (RBC), and prothrombin time and platelet count. The inverse correlation between RBCs in peripheral blood and ESR suggested that anemia associated with chronic inflammatory disease is a noncasual event in patients suffering from cardiac myxoma. Mechanical hemolysis may be only a minor component of anemia, according to the lack of correlation between echographic surface and RBCs. Moreover, tumor size did not correlate with ESR, showing that inflammatory state may depend from both tumor cells population and inflammatory infiltrate. In the future, modulation of macrophage polarization in cardiac myxomas might represent important therapeutic target.

Keywords: Cardiac myxomas; erythrosedimentation rate; innate immunity; macrophages; mast cells.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
(a) Histology and immunohistochemistry of mast cells and macrophages in myxoma samples. Histological slice stained with hematoxylin and eosin. Representative light microscopy images showing immunohistochemical detection (brown staining) of (b) c-kit (CD117), (c) tryptase, (d) CD68, (e) CD163 and (f) iNOS.
Figure 2.
Figure 2.
Double-immunofluorescence staining for CD68 and CD163 in cardiac myxomas. Composite images showing cells double-labeled for CD68 and CD163 (arrows; yellow overlay). CD68+/CD163− macrophages were also evident (arrowheads).
Figure 3.
Figure 3.
Double-immunofluorescence staining for CD68 and iNOS in cardiac myxomas. Composite images showing rare cells double-labeled for CD68 and iNOS (arrow; yellow overlay). CD68+/iNOS− macrophages were widely distributed (arrowheads).
See this image and copyright information in PMC

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