bromochloroacetic-acid and Heart-Diseases

We report the case of a rare cardiac lesion, mesothelial/monocytic incidental cardiac excrescences, and also provide a review of the literature. Diagnosis of this entity was based on both its unique morphologic features and imunohistochemical stains. Cytokeratin positivity confirmed the epithelial component, mesothelial cells, in the lesion. Positive staining of CD68 in the monocytic-appearing cells revealed the histiocytic nature of the second component of this lesion. Differential diagnoses are discussed. This report emphasizes the diagnostic dilemma encountered with this unusual entity and the possibility of misdiagnosing the epithelial portion as a metastatic lesion or vice versa.

Topics: Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Epithelium; Heart Diseases; Humans; Immunohistochemistry; Keratins; Male; Monocytes; Myocardium

Two cases of mesothelial/monocytic incidental cardiac excrescences in a 66-year-old female and an 80-year-old male are presented. Lesions had solid and tubular pattern formations which were composed of two predominant cell types of histiocytoid cells and cuboidal cells arranged in strips. The histiocytoid cells were round and had well-defined nuclei with prominent nuclear grooves. They had a low nuclear to cytoplasmic ratio. There were no atypical mitoses. Immunohistochemically, these cells were positive for leukocyte common antigen (LCA) and CD68 (KP-1) but negative for keratin. The cuboidal cells were present in strips, had haphazardly arranged surface microvilli and had small round non-cleaved nuclei. These cells were positive for keratin but negative for LCA, CD68, p53, proliferative cell nuclear antigen, alpha-smooth muscle actin, Factor VIII, epithelial membranous antigen and vimentin. These lesions are probably reactive because of their heterogeneous components; an expected feature for an essentially artifactual lesion that is related to cardiac surgery and invasive catheterization. Immunohistochemical studies are useful for avoiding misdiagnosis of neoplasms.

Topics: Aged; Aged, 80 and over; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Epithelium; Female; Heart Diseases; Histiocytes; Humans; Hyperplasia; Iatrogenic Disease; Immunohistochemistry; Keratins; Leukocyte Common Antigens; Male; Monocytes; Myocardium