Non-bacterial thrombotic endocarditis in a 74 y/o female with endometrial carcinoma. Previously known as marantic endocarditis, it consists of formation of sterile vegetations on cardiac valves and adjacent endocardium. The predisposing factors include rheumatic fever, trauma (e.g. caused by cardiac catheters), circulating immune complexes (such as those seen in SLE), hypercoagulable states, and certain mucin-producing carcinomas. Diagnosis is made by echocardiography and negative blood cultures. Treatment usually consists of anticoagulants. Image copyright: pathorama.ch.