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(American Journal of Pathology. 2003;163:2407-2412.)
© 2003 American Society for Investigative Pathology

Herpes Simplex Virus Type 1 Infection Associated with Atrial Myxoma

Yanwen Li*, Zhigang Pan{dagger}, Yuan Ji{ddagger}, Mary Sheppard§, Donald J. Jeffries, Leonard C. Archard* and Hongyi Zhang*||

From the Division of Biomedical Sciences,* Imperial College Faculty of Medicine, London, United Kingdom; the Department of General Practice,{dagger} Zhongshan Hospital, Fudan University, Shanghai, China; the Department of Pathology,{ddagger} Zhongshan Hospital, Fudan University, Shanghai, China; the Department of Histopathology,§ Royal Brompton Hospital, Imperial College Faculty of Medicine, London, United Kingdom; the Department of Virology, St. Bartholomew’s and Royal London School of Medicine and Dentistry, London, United Kingdom; and the Clinical Microbiology and Public Health Laboratory,|| Addenbrooke’s Hospital, Cambridge, United Kingdom

Some findings suggest an infectious factor in cardiac myxoma and certain histopathological features indicate herpes simplex virus type 1 (HSV-1) infection. We hypothesized that HSV-1 may be involved in the pathogenesis of cardiac myxoma. Paraffin-embedded tissue samples from 17 patients with atrial myxoma were investigated for HSV-1 antigen by immunohistochemistry and viral genomic DNA by nested polymerase chain reaction. The histogenesis and oncogenesis of atrial myxoma were assessed by the expression of calretinin, Ki67, and p53 protein, respectively. Autopsy myocardial samples, including endocardium from 12 patients who died by accident or other conditions, were used for comparison. HSV-1 antigen was detected in atrial myxoma from 12 of 17 patients: 8 of these 12 samples were positive also for HSV-1 DNA. No HSV-1 antigen or DNA was found in tissue from the comparison group. Antigens of HSV-2, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus were not found in atrial myxoma. Calretinin was found in myxoma cells of all 17 cases but Ki67 was present only in smooth muscle cells or infiltrating cells in some cases. p53 was not detectable in any myxoma. Most infiltrating cells were cytotoxic T lymphocytes. These data suggest that HSV-1 infection is associated with some cases of sporadic atrial myxoma and that these may result from a chronic inflammatory lesion of endocardium.






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Copyright © 2003 by the American Society for Investigative Pathology.