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MICE - A matter of Heart
Mesothelial/monocytic incidental cardiac excrescence (MICE)
Mesothelial/monocytic incidental cardiac excrescence (MICE) is a very rare benign lesion found incidentally in the left cardiac chambers and on valve surfaces, especially during aortic and mitral valve surgery or in endomyocardial biopsy specimens.
Mesothelial/monocytic incidental cardiac excrescence" was introduced by Veinot et al in 1994.
This pseudo-tumor histologically shows solid cell clusters within a meshwork of fibrin.
The lesion is composed of a mixture of histiocytes, mesothelial cells, fibrin, adipocytes, and inflammatory cells without a vascular network or supporting stroma.
The cells are round to polygonal with eosinophilic cytoplasm, sometimes the cells have a foamy or vacuolated appearance with distinct cell borders. These cells have a histiocytoid or epithelioid like appearance.
In areas the tumour may show gland-like or papillary structures of small cuboidal cells.
Immunohistochemistry reveals the biphasic nature of the lesion with cytokeratin positivity of the cuboidal cells and CD68 (KP-1) positivity of the histiocytes.
These lesions should not be mistaken for a primary or metastatic malignant tumour.
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