1. What's in a Mass?: Large Native Mitral Valve Mass
Stacey J. Howell, MD, Ananya Datta Mitra, MD, Ezra A. Amsterdam, MD 
The American Journal of Medicine 
Volume 130, Issue 5, Pages e171-e175 (May 2017)
DOI: /j.amjmed
Copyright © 2017 Elsevier Inc. Terms and Conditions

2. Figure 1
(A) Transthoracic echocardiogram, parasternal long-axis view, demonstrates suggestion of a mass (arrow) adjacent to the anterior leaflet of the mitral valve. (B) Transesophageal echocardiogram, midesophageal 2-chamber view in diastole and (C) systole, clearly shows the mitral valve mass. The mass is attached to the anterior mitral leaflet, measuring 2.2 × 1.5 cm. AO = aorta; LA = left atrium; LV = left ventricle; RV = right ventricle.
The American Journal of Medicine  , e171-e175DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions

3. Figure 2
Cardiac computed tomography obtained for surgical planning before cardiothoracic surgery highlights the sizable mitral valve mass as demonstrated by the large filling defect (arrow).
The American Journal of Medicine  , e171-e175DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions

4. Figure 3
Intraoperative viewing of excised mitral valve mass. The mass involved 50% of the medial aspect of the anterior mitral leaflet with attachment to multiple major chordae.
The American Journal of Medicine  , e171-e175DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions

5. Figure 4
Pathology including gross specimen (A) and histology (B-E). (A) Mitral valve leaflets with partially disrupted 2.2 × 1.5 × 1.5-cm polypoid nodule with a smooth tan-brown outer surface and brown-red inner soft tissue. (B) Entire cross-section of the mitral valve mass showing intramural thrombus (center) (hematoxylin–eosin, magnification 2×). (C) Low-power view of the mitral valve mass showing intramural thrombus (arrow) with dense acute inflammation (center) (hematoxylin–eosin, magnification 10×). (D) High-power field of the mitral valve mass (C) showing dense acute inflammation (hematoxylin–eosin, magnification 50×). (E) Low-power view of the mitral valve mass showing significant increase in hemosiderin-laden macrophages (hematoxylin–eosin, magnification 10×).
The American Journal of Medicine  , e171-e175DOI: ( /j.amjmed )
Copyright © 2017 Elsevier Inc. Terms and Conditions