Occurrence of mesothelial/monocytic incidental cardiac excrescences in material from open-heart procedures: case reports and literature review

Mesothelial/monocytic incidental cardiac excrescences (MICE) are unusual findings during the histological analysis of material from the pericardium, mediastinum, or other tissues collected in open-heart surgery. Despite their somewhat worrisome histological appearance, they show a benign clinical co...

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Bibliographic Details
Published inAutopsy & case reports Vol. 8; no. 1; p. e2018002
Main Authors Grossi, Vitor Gabriel Ribeiro, Lee, Karen, Demarchi, Léa Maria, Castelli, Jussara Bianchi, Aiello, Vera Demarchi
Format Journal Article
LanguageEnglish
Published Brazil São Paulo, SP: Universidade de São Paulo, Hospital Universitário 01.01.2018
University of São Paulo
Subjects
Clinical Case Report
Heart DiseasesIncidental FindingsEpitheliumHistiocytes
Heart Diseases
Incidental Findings
Epithelium
Histiocytes
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Summary:Mesothelial/monocytic incidental cardiac excrescences (MICE) are unusual findings during the histological analysis of material from the pericardium, mediastinum, or other tissues collected in open-heart surgery. Despite their somewhat worrisome histological appearance, they show a benign clinical course, and further treatment is virtually never necessary. Hence, the importance of recognizing the entity relays in its differential diagnosis, as an unaware medical pathologist may misinterpret it for a malignant neoplasm. Other mesothelial and histiocytic proliferative lesions, sharing very close histological morphology and immunohistochemistry features with MICE, have been described in sites other than the heart or the mediastinum. This similarity has led to the proposal of the common denomination "histiocytosis with raisinoid nuclei." We report three cases from the pathology archives of the Heart Institute of São Paulo University (Incor/HC-FMUSP), diagnosed as "mesothelial/monocytic incidental cardiac excrescence," with immunohistochemical documentation, and provide a literature review of this entity.
Bibliography:Conflict of interest: None
Authors contributions: All authors have significantly contributed, and are in agreement with the content of the manuscript. Grossi VGR designed and wrote the manuscript after gathering all the required information; contributed with the literature review. Lee K did the literature search and made valuable additions to the discussion; provided the picture’s documentation and proof-read the manuscript. Demarchi LM and Castelli JB gathered relevant clinical information and follow up data. Aiello VD participated in the process of manuscript design, proof-read it, and provided valuable input to improve the case descriptions and discussion.
ISSN:2236-1960
2236-1960
DOI:10.4322/acr.2018.002