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Objectives:Primary cardiac tumors are rare and account for 0.001 to 0.03% of cardiac lesions. The authors aim to describe the clinical, the microscopic and the therapeutic characteristics of these tumors through a 13-year-experience in order to highlight the diagnostic challenges faced.Methods:We report 10 primary cardiac tumors diagnosed in the Departments of Pathology and Thoracic Surgery of the same hospital through a 13-year-period.Results:Our study was conducted on 7 women and 3 men. The mean age of the patients was 54.22 years (average, 12 to 79 years). Dyspnea represented the most frequent symptom. Physical examination was normal in all patients. Trans-thoracic ultra-sound examination was performed in all patients. Cardiac MRI allowed localizing the tumors in 2 patients. They were located into the left auricle (6 cases), the right auricle (1 case) and the pericardium (3 cases). The microscopic examination was concluded to myxoma (7 cases), haemangioma (2 cases) and hemangioendothelioma (1 case). Surgical resection was possible in 9 patients. It was impossible in the case of hemangioendothelioma because of the adherence. One death was recorded secondary to postoperative arrhythmia. The other patients presented no complications after a follow-up period ranging from 2 months to 5 years.Conclusion:Cardiac tumors are challenging in their diagnosis and management. A positive diagnosis is based on microscopic examination. Surgical treatment plays a key role and is possible in the majority of benign tumors. The prognosis of malignant tumors remains poor even if a complete surgical resection is possible.

Background: Lymphoblastic lymphomas (LL) of the mediastinum are rare tumours that present a challenging diagnosis. The positive diagnosis is based on microscopic findings. Our aim was to highlight the diagnostic difficulties in such situations. Methods: We conducted a descriptive retrospective study including 31 patients presenting mediastinal LL. Results: Radiologic features consisted in all cases in a mediastinal infiltrating mass. Microscopic examination showed in all cases a crowded tumour with many artefacts made of diffuse tumour cells. Immunohistochemial study was performed in all cases. It was quite difficult to interprete in the samples used for extemporaneous examination and repeated in 10 cases. Conclusion: The diagnosis of LL is based on the microscopic examination which is usually performed on small samples with crowding artefacts. Thus, this pathology must be managed by a trained team that is used to deal with such a specimen in order to avoid repeating the biopsy and inducing diagnostic delay.

Background The accurate microscopic diagnosis of lung cancer has become insufficient due to the concept of personalized medicine. Tissue samples are used not only for microscopic diagnosis but also for the assessment of the different targets. Biopsies are performed in 80% of the patients and they are not sufficient for molecular diagnosis in 30% of the cases. Liquid biopsy (LB) has been reported as a possible surrogate to tissue samples and has been introduced in the management scheme of the patients since 2014. We aimed to highlight the diagnostic value of liquid biopsy in assessing the molecular profile of non small cell carcinomas in comparison with tissue biopsy. Methods We retracted eligible articles from PubMed, Embase and Cochrane databases. We calculated the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR). A summary receiver operating characteristic curve (SROC) and area under curve (AUC) were used to evaluate the overall diagnostic performance using the Meta-Disc software 5.1.32. The heterogeneity was assessed using I square statistics. A meta-regression was performed in case of heterogeneity. In case of absence of covariates, a sensitivity analysis was done in order to assess publications that induced a statistical bias. Results 39 eligible studies involving 4782 patients were included. The overall statistical studies showed heterogeneity in the SEN, SPE, PLR, NLR and DOR. No threshold effect was revealed. The meta-regression incorporating the ethnicity, the test, the technique used in tissue and plasma and the use of plasma or serum as covariates showed no impact of these factors. A sensitivity analysis allowed achieving the homogeneity in the SPE and DOR. The overall pooled SEN and SPE were 0.61 and 0.95 respectively. The PLR was 9.51, the NLR was 0.45 and DOR was 24.58. The SROC curve with AUC of 0,93 indicated that the liquid biopsy is capable of identifying wild type samples from mutated ones with a relatively high accuracy. Conclusion This meta-analysis suggested that detection of molecular mutations by cfDNA is of adequate diagnostic accuracy in association to tissues. The high specificity and the moderate sensitivity highlight the value of LB as a screening test.

Background: Multiple thoracic hydatidosis is uncommon even in endemic countries. Case Presentation: A 37-year-old Caucasian man came to our observation with a 10-day history of basi-thoracic chest pain and dyspnea. Chest X-ray showed a well limited cardiac opacity associated to an opacity of the upper lobe of the right lung. Chest CT-scan showed a mediastinal cyst evoking a hydatid cyst in the left ventricle associated to a right pleural effusion. The patient underwent surgery that consisted in the drainage of multiple pericardial cysts, cystectomy of a left ventricle cyst and right pleural cystectomy. Microscopic examination showed a pleuro-pulmonary and cardio- pericardial hydatidosis. The patient was treated with albendazole and did not present complications or recurrences after one year of follow up. Conclusion: Multiple thoracic hydatidosis is rare. Cardiac location is most challenging because it is difficult to manage and life threatening. Treatment modalities continue to be based mainly on surgery. Preventive measures are necessary to avoid disease recurrence.