METASTATIC PULMONARY EMBOLI - CLINICAL TYPES AND INCIDENCE

Abstract

Pathological examinations during autopsy of 1457 cases of cancer demonstrated the presence of metastatic pulmonary emboli in 10% (148 cases). They were divided, as a function of their site and histological type of the primary neoplasm, as follows : hepatoma 33%, chorioepithelioma 25%, endocrine glands 19%, biliary tract 17.6%, hypernephroma 15.6%, sarcoma 13%, and various other tumors such as cancer of the pancreas and breast. Two anatomical types of these emboli can be distinguished : 1 mixed type associated with a pulmonary cancerous lymphangitis (90 cases), and observed at a later stage in the disease. This may be latent or cause a subacute cor pulmonale. The other type is not associated with lymphangitis (58 cases), results from hematogenic cancers (hepatoma, hypernephroma, etc.), is often seen at an early stage and causes sudden death. Histological examination enabled the consequences of any infarct developing as a result of the emboli to be demonstrated, and the origin of the emboli from neoplasmatic thromboses in the primary cancer drainage routes or from metastases in the liver to be determined.