An extensive work-up was performed, and she was treated for tracheobronchitis or early pneumonia. The work-up had included an echocardiogram, and the imaging showed a 2 x 1.7 cm right atrial mass. Cardiac magnetic resonance (CMR) imaging showed a structure in the posterior aspect of the right atrium that appeared to be broad-based with extension into the right atrium. It moved with the right atrial wall contraction, but there was no prolapse through the tricuspid valve into the right ventricle

and no obvious stalk was identified (Fig 1). Figure 1 Cardiac MRI: Image A is four-chamber steady state free Inhibitors,research,lifescience,medical precision showing mass in the posterior aspect of the right atrium that appears to be broad-based with extension into the right atrium (white arrow). Images B and C are T1 and T2 turbo-spin echo images … After completion of the cardiac MRI and a cardiac catheterization study, the patient underwent surgical resection of the mass under the clinical diagnosis Inhibitors,research,lifescience,medical of cardiac myxoma. The patient was successfully treated and discharged home, and she is free of disease after 1 year of postsurgical follow-up. Gross and Histopathologic Findings of Cardiac Mass Gross examination revealed Inhibitors,research,lifescience,medical a 1.9 x 1.3 x 0.8 cm tan-pink piece of soft tissue mass with a glistening, smooth pericardium on one side and scattered gritty calcifications on the opposite side. Also submitted in the

same container were several tan-pink muscle fragments (1.0 x 0.9 x .5 cm in aggregate, ranging from 0.2 cm to 1.1 cm in greatest dimension).

Microscopic examination of the cardiac mass showed nodular calcified amorphous debris with admixed degenerated fibrin and focal chronic inflammation (Figure 2). This organizing fibrinous process extended to the periphery Inhibitors,research,lifescience,medical of the sampled tissue; however, it did not involve the underlying myocardial tissue or the pericardium. No frank necrosis, pleomorphism, or mitoses was seen. Figure 2 Cardiac CAT. Nodular calcified Inhibitors,research,lifescience,medical amorphous debris with admixed degenerated fibrin (hematoxylin and eosin stain; original magnification x20) Discussion Cardiac CAT is a rare entity first described by Reynolds et al. in 1997. They reported 11 intracardiac masses that had microscopic Florfenicol features of calcification and amorphous fibrinous material and suggested the current nomenclature of cardiac CAT to describe this entity.16 Histologically, a cardiac CAT consists of calcification and eosinophilic amorphous material in the background of dense collagenous fibrous tissue. There is a slight female predominance (62.5%) and wide range of age at diagnosis (18-78 years), with the mean age of presentation at 51 years (Table 1). The patient in our case was slightly older at age 57. The patients are mostly check details asymptomatic at presentation (43.75%). The masses may cause symptoms related to obstruction or embolization such as shortness of breath (31.25%), syncope (12.5%), and central retinal arterial occlusion (6.25%). A cardiac mass may induce recurrent ventricular arrhythmia (6.