Abstract
Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare entity which is an amalgam of mesothelial cells, histiocytes, and fibrin, often found occasionally during cardiac valve replacement. We report a case in a 25-year-old Chinese female with serous mitral stenosis and patent foramen ovale. Routine and immunohistochemical stains and ultrastructure examination revealed the vegetation was predominantly composed of histocytes with scattered mesothelial cells. In fact nodular histiocytic/mesothelial hyperplasia (NHMH) is a similar lesion to MICE. MICE and NHMH could be unified, and NHMH may be a better choice.
Highlights
Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare entity composed of a haphazard mixture of histiocytes, mesothelial cells, fibrin, adipocytes, and inflammatory cells without a vascular network or supporting stroma
We propose to unify MICE and nodular histiocytic/mesothelial hyperplasia (NHMH), and NHMH may be a better choice
The epithelial strips composed of cuboidal to low columnar cells, showing strong membranous immunostaining for cytokeratin AE1/AE3 (Fig. 1C) and cytokeratin 5/6, strong nuclear and cytoplasmic immunostaining for calretinin, and nuclear immunostaining for WT-1, supporting its mesothelial origin
Summary
Background Mesothelial/monocytic incidental cardiac excrescence (MICE) is a rare entity composed of a haphazard mixture of histiocytes, mesothelial cells, fibrin, adipocytes, and inflammatory cells without a vascular network or supporting stroma. There were two hypotheses that were proposed to explain how the mesothelial cells ''gain'' access into the intravascular compartment. MICE may be just a reactive lesion which results from imflammation, mechanic irritation, or tumor. Nodular histiocytic/mesothelial hyperplasia (NHMH) is a similar entity to MICE.
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