NONBACTERIAL THROMBOTIC ENDOCARDITIS - RE VIEW OF A NECROPSIC SERIES

Nonbacterial thrombotic endocarditis (NBTE) is characterized by the de position of thrombi on undamaged heart valves and by the increased fre quency of associated arterial embolic events in patients with chronic debilitating diseases, Fifteen subjects diagnosed by necropsy of nonba cterial thrombotic endocarditis (NBTE) were studied to evaluate the ge neral features, associated diseases, arterial embolic events, distribu tion and characteristics of histologic lesions, The most common underl ying disease was neoplasm, which was present in 10 cases. Of these, 6 were adenocarcinomas, 3 hematological, and the remaining case was a bl adder carcinoma, Other associated diseases included amyloidosis, MELAS syndrome, and sepsis. In most cases peripheral arterial embolic event s were detected (9 cases), The central nervous system and the lung wer e involved in 7 cases (78%), heart and kidneys in 5 cases (56%), and s pleen in 4 cases (44%). Other involved organs included pancreas, thyro id gland, testicles, meninges, liver and adrenal glands. The left valv es were predominantly involved. The mitral valve in eight cases and th e aortic valve in six cases. All cases with right involvement had the antecedent of central venous catheterization. Subendothelial fibrosis was a common histological finding which revealed the chronicity of the disease.