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Lesion of aggregated monocytes and mesothelial cells: mesothelial/monocytic incidental cardiac lesion.
[acute rheumatic fever]
A
58
-
year
-old
woman
with
a
history
of
childhood
acute
rheumatic
fever
and
resultant
mitral
valve
stenosis
was
admitted
to
our
cardiovascular
surgery
clinic
complaining
of
tachycardia
,
dyspnea
,
and
chest
pain
.
After
clinical
and
radiological
findings
were
evaluated
,
mitral
valve
replacement
,
tricuspid
De
Vega
annuloplasty
and
plication
,
and
resection
of
giant
left
atrium
were
performed
.
Atrial
thrombus
was
removed
from
the
top
of
the
left
atrial
wall
.
Operation
material
considered
as
thrombus
was
sent
to
a
pathology
laboratory
for
histopathological
examination
.
It
was
diagnosed
with
mesothelial
/
monocytic
incidental
cardiac
lesion
(
cardiac
MICE
)
.
Microscopic
sections
revealed
that
morphological
features
of
the
lesion
were
different
from
thrombus
.
The
lesion
was
composed
of
a
cluster
of
histiocytoid
cells
with
abundant
cytoplasm
and
oval
shaped
nuclei
and
epithelial-like
cells
resembling
mesothelial
cells
within
a
fibrin
network
.
Epithelial-like
cells
formed
a
papillary
configuration
in
the
focal
areas
.
Mitotic
figures
were
absent
.
Here
we
present
a
case
which
was
incidentally
found
in
a
patient
who
underwent
mitral
valve
replacement
surgery
,
as
a
thrombotic
lesion
on
the
left
atrium
wall
.
Diseases
Validation
Diseases presenting
"resultant mitral valve stenosis was admitted to our cardiovascular surgery clinic complaining of tachycardia"
symptom
acute rheumatic fever
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