A case of mesothelial/monocytic incidental cardiac excrescence and literature review

Hu, Ziyi; Lü, Hui; Yin, Hongling; Wen, Ji; Jin, Ou

doi:10.1186/1746-1596-5-40

Cited by 18 publications

(9 citation statements)

References 9 publications

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Section: Introductionmentioning

confidence: 99%

“…Sometimes it has been reported in the pericardium [7,8] or presenting as an inguinal mass [9]. The 'mesothelial/monocytic incidental cardiac excrescence', first described by Weinot et al in 1994 [10] is now considered a similar lesion to NHMH [11].It consists of a reactive proliferation of histiocytes and mesothelium secondary to chronic irritation and it has been observed in pleura-damaging processes, such as pneumothorax [5], or as consequence of cardiac catheterization, inflammation, mechanical or tumor stimulation [11].The rarity of NHMH and the moderate cytological atypia often present, make this lesion difficult to diagnose. It can be easily confused with primary mesothelial lesions and neoplasms such as adenocarcinomas, granulosa cell tumors or Langerhans' histiocytosis.…”

mentioning

confidence: 99%

“…It consists of a reactive proliferation of histiocytes and mesothelium secondary to chronic irritation and it has been observed in pleura-damaging processes, such as pneumothorax [5], or as consequence of cardiac catheterization, inflammation, mechanical or tumor stimulation [11].…”

Section: Introductionmentioning

confidence: 99%

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Nodular Histiocytic/Mesothelial Hyperplasia as Consequence of Chronic Mesothelium Irritation by Subphrenic Abscess

et al. 2015

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Purpose: Pleural nodular histiocytic/mesothelial hyperplasia is a nodular histiocytic/ mesothelial proliferation, often delimiting cystic cavities, due to irritation by a pulmonary noxa. Case report results: The patient had right pleural parietal and diaphragmatic thickness, with pleural effusion, without lung alterations. He previously underwent left hemicolectomy and liver resection, due to a diverticulitis and a liver histiocytes-rich abscess. Video-assisted thoracoscopy biopsy showed a double population of reactive mesothelial cells and histiocytes. Conclusion: Nodular histiocytic/mesothelial hyperplasia represents a potential pitfall for pathologists. Immunohistochemistry is crucial for the differential diagnosis with some malignancies. We suggest that in our patient, a chronic mesothelium inflammation happened by transdiaphragmatic involvement as a consequence of the liver abscess. Some pathogenetic mechanisms are hypothesized. KEYWORDS• mesothelial hyperplasia • pleural effusion • VATS Nodular histiocytic/mesothelial hyperplasia (NHMH) is a benign localized alteration, first described in 1975 by Rosai in the hernia sac [1]. Few pulmonary cases have been reported in literature [2][3][4][5][6]. Sometimes it has been reported in the pericardium [7,8] or presenting as an inguinal mass [9]. The 'mesothelial/monocytic incidental cardiac excrescence', first described by Weinot et al. in 1994 [10] is now considered a similar lesion to NHMH [11].It consists of a reactive proliferation of histiocytes and mesothelium secondary to chronic irritation and it has been observed in pleura-damaging processes, such as pneumothorax [5], or as consequence of cardiac catheterization, inflammation, mechanical or tumor stimulation [11].The rarity of NHMH and the moderate cytological atypia often present, make this lesion difficult to diagnose. It can be easily confused with primary mesothelial lesions and neoplasms such as adenocarcinomas, granulosa cell tumors or Langerhans' histiocytosis.We report a case of pleural NHMH in a patient with a subphrenic abscess, in which no pulmonary pathogenic noxa was evident. We hypothesize a transdiaphragmatic chronic irritation as a pathogenetic mechanism underlying NHMH. Case reportA 57-year-old man presented to our department in June 2014, due to the presence of a right pleural effusion with undefined diagnosis. At admission he had no fever, infections or history of exposure to asbestos and other dust. Shortness of breath after moderate exertion was noted, blood pressure was 130/85 mmHg and heart rate 77 bpm with normal sinus rhythm. Physical examination showed abolition of breath sounds and fremitus on all fields on the right side and dullness plexus. The patients drug history was negative. Due to the onset of pleural effusion and dyspnea, the patient For reprint orders, please contact: reprints@futuremedicine.com

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Section: Introductionmentioning

confidence: 99%

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Nodular Histiocytic/Mesothelial Hyperplasia as Consequence of Chronic Mesothelium Irritation by Subphrenic Abscess

et al. 2015

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“…With regard to etiopathogenesis, cardiac MICE formation in the patient mentioned before has not yet been elucidated. Some authors have speculated that cardiac MICE may be just a reactive lesion which results from inflammation or tumor [8]. …”

Section: Discussionmentioning

confidence: 99%

Lesion of Aggregated Monocytes and Mesothelial Cells: Mesothelial/Monocytic Incidental Cardiac Lesion

Erinanç

Gülbaran

Saba

et al. 2013

Case Reports in Pathology

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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.

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“…The reactive theory stated that MICE may be a reactive lesion as a result of inflammation, mechanic irritation (cardiac catheterization) or tumor. The artifact theory postulated that MICE are artifactual, formed by the manipulation of the cardiac surgeon, compacted by suction vacuum at the time of the procedure (3,10). In our case, no prior cardiac catheterization or cardiac surgery was performed.…”

Section: Discussionmentioning

confidence: 99%

Mesothelial/Monocytic incidental cardiac excrescences (MICE) with primary cardiac leiomyosarcoma: Report of the first case

Baktır¹,

Şarlı²,

Çiçek³

et al. 2015

Turk J Bioch

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Nefes darlığı ve bayılma şikayeti ile kardiyoloji polikliniğine başvuran 74 yaşındaki erkek hastanın yapılan transtorasik ekokardiyografisinde sol atriyum içerinde kitle saptandı. Transözefageal ekokardiyografide bir tanesi sol atriyum duvarı ve mitral kapak arka yaprakçığının atriyal yüzüne geniş tabanlı olarak bağlanmış, diğeri ise ilk parçaya bitişik olan 2 parçalı sol atriyal kitle saptandı ve hasta operasyon amaçlı kalp damar cerrahisine devredildi. Cerrahi olarak çıkarılan kitlenin histopatolojik incelemesi mezotelyal/monositik rastlantısal kardiyak tümör (MRKT) ve düşük grade'li leiomiyosarkom olarak rapor edildi. Yapılan literatür incelemesinde, MRKT ve primer kardiyak leiomiyosarkom birlikteliği bildirilmemiştir. Bu yazıda nefes darlığı ve bayılma şikayeti sonrası tanı konulan bu nadir kardiyak kitle ekokardiyografik ve histopatolojik bulguları ile birlikte sunulmuştur.A 74-year-old man was admitted to outpatient cardiology clinic with the compliant of shortness of breath. After evaluation of the patient, transthorasic echocardiography revealed left atrial mass. Transesophageal echocardiography demonstreated a left atrial mass with two lobule, one attached to left atrial wall and atrial side of posterior mitral leaflet with a wide base, the other one was adjacent to the first one and patient refered to cardiac surgery. Histopathological diagnosis of masses revealed Mesothelial/monocytic incidental cardiac excrescence (MICE) and low grade leiomyosarcoma. According to our search of literature did not yield any report of a case with occurance of primary cardiac leiomyosarcoma MICE together. Thus, we discuss herein this rare cardiac mass presented with shortness of breath and syncope, together with the findings on echocardiography and histopathology. Anahtar Kelimeler: Kardiyak tümör, kardiyak leiomiyosarkom, sol atriyal kitle, mezotelyal/monositik rastlantısal kardiyak tümör.

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A case of mesothelial/monocytic incidental cardiac excrescence and literature review

Cited by 18 publications

References 9 publications

Nodular Histiocytic/Mesothelial Hyperplasia as Consequence of Chronic Mesothelium Irritation by Subphrenic Abscess

Nodular Histiocytic/Mesothelial Hyperplasia as Consequence of Chronic Mesothelium Irritation by Subphrenic Abscess

Lesion of Aggregated Monocytes and Mesothelial Cells: Mesothelial/Monocytic Incidental Cardiac Lesion

Mesothelial/Monocytic incidental cardiac excrescences (MICE) with primary cardiac leiomyosarcoma: Report of the first case

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