title: Survivin expression in cardiac myxoma.
abstract: BACKGROUND
  Cardiac myxoma, the most common primary tumor of the heart, has variable clinical presentations and an immunohistochemical profile. Survivin, an antiapoptosis protein, may play an important role in the causes of cardiac myxoma. This investigation will report the expression pattern of survivin in cardiac myxomas.
  
  
  METHODS
  This study included 40 patients with cardiac myxoma, who were treated with surgical excision of the lesion. Detailed clinical parameters were reported and the expression of survivin was studied by immunohistochemical staining.
  
  
  RESULTS
  The patient population was comprised of 24 (60%) women and 16 (40%) men. The mean age of the patients was 42 years, with an age range of 30 to 63 years. All study cases were sporadic myxomas rather than familial myxoma. Patients were asymptomatic (20%), or had dyspnea (40%), stroke (15%), chest pain (12%), and fever (12%) on presentation. All lesions were located in the left atrium. The location of the myxoma and clinical events did not differ in terms of pathological changes, such as vascular proliferation, inflammation, cellularity, hyaline, calcification and thrombosis. Cardiac myxoma was characterized by a survivin dependent pathway with 100% immunohistochemical staining in the cytoplasm and the distribution in scoring system of survivin expression were 1 case (2.5%) in score 1; 12 cases (30%) in score 2; 12 cases (30%) in score 3 and 15 (37.5%) in score 4.
  
  
  CONCLUSIONS
  Cardiac myxomas demonstrate strong expression of survivin in the cytoplasm. This implies survivin may play an important role in the apoptosis pathway in cardiac myxomas.
authors: Division of Cardiology, Chang Gung Memorial Hospital at Chiayi, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors: Yu-Sheng
authors: YS
authors: Lin
authors: Shih-Ming
authors: SM
authors: Jung
authors: Hsueh-Hwa
authors: HH
authors: Wu
authors: Tzu-Fang
authors: TF
authors: Shiu
authors: Feng-Chun
authors: FC
authors: Tzai
authors: Jaw-Ji
authors: JJ
authors: Chu
authors: Pyng-Jing
authors: PJ
authors: Lin
authors: Pao-Hsien
authors: PH
authors: Chu
mesh_terms: D000328:Adult; D005260:Female; D006338:Heart Neoplasms / Q000737:chemistry* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D009232:Myxoma / Q000737:chemistry* / Q000473:pathology; D000077022:Survivin
chemical_list: C107489:BIRC5 protein, human; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin