Nonbacterial Thrombotic Endocarditis Presenting as a Mass in the Right Atrium Diagnosed by Open Chest Surgery: A Case Report

Asami Yamashita; Shinji Hisatake; Kojiro Sakurai; Yoshiki Murakami; Toshio Kinoshita; Yoshio Nunoi; Shinnosuke Okuma; Fujii Takeshiro; Yuri Fukasawa; Naobumi Tochigi; Takanori Ikeda

doi:10.2169/internalmedicine.2622-23

Asami Yamashita, Shinji Hisatake, Kojiro Sakurai, Yoshiki Murakami, Toshio Kinoshita, Yoshio Nunoi, Shinnosuke Okuma, Fujii Takeshiro, Yuri Fukasawa, Naobumi Tochigi, Takanori Ikeda

Author information

Asami Yamashita
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Japan
Shinji Hisatake
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Japan
Kojiro Sakurai
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Japan
Yoshiki Murakami
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Japan
Toshio Kinoshita
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Japan
Yoshio Nunoi
Division of Cardiovascular Surgery, Department of Surgery, Toho University Faculty of Medicine, Japan
Shinnosuke Okuma
Division of Cardiovascular Surgery, Department of Surgery, Toho University Faculty of Medicine, Japan
Fujii Takeshiro
Division of Cardiovascular Surgery, Department of Surgery, Toho University Faculty of Medicine, Japan
Yuri Fukasawa
Department of Pathology, Toho University Faculty of Medicine, Japan
Naobumi Tochigi
Department of Surgical Pathology, Toho University Faculty of Medicine, Japan
Takanori Ikeda
Division of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Japan

Keywords: Non-bacterial thrombotic endocarditis, mass in the right atrium, surgery for non-bacterial thrombotic endocarditis, antiphospholipid syndrome, cancer

JOURNAL OPEN ACCESS Advance online publication

Article ID: 2622-23

DOI https://doi.org/10.2169/internalmedicine.2622-23

Details

Abstract

Nonbacterial thrombotic endocarditis (NBTE) is a condition that results in the development of vegetation on cardiac valves that are devoid of inflammation and bacteria. We herein report a 60-year-old man who transferred to our hospital because of a systemic embolism and heart failure. A mass in the right atrium and vegetation on the mitral valve were observed. He was first diagnosed with infectious endocarditis according to the Duke criteria. During treatment, however, the patient was diagnosed with antiphospholipid syndrome and cancer. After four weeks of antibacterial therapy, the patient underwent open chest surgery, and the postoperative histological diagnosis was NBTE.

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