• Hardeep Kaur Grewal, Manish Bansal, Rahul Mehrotra, Raj Kumar, Roopa Salwan, Anil Bhan, Dheeraj Gautam, and Ravi R Kasliwal.
• Department of Cardiology, Cardiothoracic Surgery and Pathology, Medanta - The Medicity, Sector 38, Gurgaon 122001, Haryana, India.
• Natl Med J India. 2020 Jan 1; 33 (1): 19-21.

AbstractA 25-year-old female, with systemic lupus erythematosus and antiphospholipid antibody syndrome, presented with exertional dyspnoea. Echocardiography showed a large (2.0 cm × 1.1 cm), echogenic, heterogeneous mass in the left ventricular outflow tract, under the aortic valve, attached to the ventricular aspect of the anterior mitral leaflet. Tiny flagellar, frond-like structures were seen attached to the surface of the mass. There was mitral regurgitation. These echocardiographic features were suggestive of a papillary fibroelastoma, but the histopathology of the excised mass revealed it to be a thrombus, which was consistent with a diagnosis of non-bacterial thrombotic endocarditis (NBTE). This case represents a rare histopathologically confirmed NBTE presenting as an unusually large mass in the left ventricular outflow tract.

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