On the cusps of both the aortic and mitral valves there are small fibrous nodules.
This patient had a carcinoma of the cystic duct with regional lymphatic metastases, as
well as metastases in the liver, lung, and on the diaphragm. The endocarditis was an incidental
finding. The vegetations are non-bacterial; they are related to the presence of malignant disease.