An example of Lambl's excrescences by transesophageal echocardiogram: a commonly misinterpreted lesion.

Lambl's excrescences are thin, mobile, filiform structures, often referred to as valvular strands in the echocardiography literature. These valvular strands may occur as a single strand, in rows, or clusters. The differential diagnosis for these excrescences includes fibroelastoma, myxoma, thrombi, vegetations, and cardiac neoplasms and metastases. Most difficult is the distinction between Lambl's excrescences and fibroelastomas. Studies regarding the clinical importance of these valvular strands are contradictory. Surgical intervention versus conservative observation should be determined on a case-by-case basis. The transesophageal views of Lambl's excrescences in this case report are meant to serve as a classic example of this commonly misinterpreted lesion.