$re = '/\b(?!(?:LV|and|normal|(?<=\bno\s+)cardiac|indexed|heart)\b)\w+\s+mass\b/mi';
$str = 'There is a 2mm mass in the RA
large irregular mass in the left ventricle
LV mass: 135g
Normal heart mass
fact that cardiac mass is valid but no cardiac mass is invalid.';
preg_match_all($re, $str, $matches, PREG_SET_ORDER, 0);
// Print the entire match result
var_dump($matches);
Please keep in mind that these code samples are automatically generated and are not guaranteed to work. If you find any syntax errors, feel free to submit a bug report. For a full regex reference for PHP, please visit: http://php.net/manual/en/ref.pcre.php