Jd. Gay et al., CLINICAL AND MORPHOLOGIC FEATURES OF LIPOMATOUS HYPERTROPHY (MASSIVE FATTY DEPOSITS) OF THE INTERATRIAL SEPTUM, The American journal of forensic medicine and pathology, 17(1), 1996, pp. 43-48
Lipomatous hypertrophy of the interatrial septum (''massive fatty depo
sits in the atrial septum'') may represent an incidental autopsy findi
ng or may be associated with atrial arrhythmias, obstructive symptoms,
or sudden death. Antemortem diagnosis is becoming much more common. I
n a literature review and in a review of our 12 cases, this condition
was found to occur more frequently in obese middle-aged or elderly sub
jects, who frequently demonstrated atherosclerotic coronary artery dis
ease. The unencapsulated mass generally occurred anterior or superior
to the fossa ovalis, and histologically was characterized by mature fa
t with varying quantities of fetal fat, inflammation and fibrosis, and
entrapment of myocardial fibers with cytologic atypia. Cases were inc
luded that had a minimum atrial septal thickness of 1.0 cm. The septum
ranged up to 7.0 cm in maximum thickness (2.6 cm average). In our cas
es, no deaths were directly attributed to this disorder. It is importa
nt that forensic pathologists become more generally aware of this cond
ition. To further delineate the true pathological significance, the at
rial septum should be routinely examined by palpation and sectioning t
o determine its thickness and fat content.