Hi @thisnthat. I am tagging @acnacf and @gset have discussed Papillary Fibroelastoma. They may be able to shed more light about it and how it compares to Lambl’s excrescence.

Here is an article from 2019 affirming your experience stating most Lambl’s Excrescences (LEs) are found incidentally. It does also say asymptomatic patients with LE should be closely monitored with TEE follow-up. It goes further to discuss patients that have symptoms.

- NIH Lambl’s Excrescences: Current Diagnosis and Management
https://pmc.ncbi.nlm.nih.gov/articles/PMC6681848/
You mention testing for mitral valve prolapse (MVP) and mitral regurgitation (MR). Are you dealing with this or is it something your doctor is trying to diagnose?