Chomette G, Auriol M, Sevestre C, Acar J
Ann Med Interne (Paris). 1980;131(4):217-21.
Pathological examinations during autopsy of 1457 cases of cancer demonstrated the presence of metastatic pulmonary emboli in 10 p. cent (148 cases). The were divided, as a function of their site and histological type of the primary neoplasm, as follows: hepatoma 33 p. cent, chorioepithelioma 25 p. cent, endocrine glands 19 p. cent, biliary tract 17.6 p. cent, hypernephroma 15.6 p. cent, sarcoma 13 p. cent, and various other tumors such as cancer of the pancreas, and breast. Two anatomical types of these emboli can be distinguished: one 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.
对1457例癌症患者进行尸检的病理检查显示,10%(148例)存在转移性肺栓塞。根据原发肿瘤的部位和组织学类型,将其分为以下几类:肝癌33%,绒毛膜上皮癌25%,内分泌腺19%,胆道17.6%,肾上腺皮质癌15.6%,肉瘤13%,以及其他各种肿瘤,如胰腺癌和乳腺癌。这些栓子可分为两种解剖类型:一种是与肺癌性淋巴管炎相关的混合型(90例),在疾病后期观察到。这可能是潜伏性的,或导致亚急性肺心病。另一种类型与淋巴管炎无关(58例),由血源性癌症(肝癌、肾上腺皮质癌等)引起,常在疾病早期出现,并导致猝死。组织学检查能够证实由于栓子形成而发生的任何梗死的后果,并确定栓子源于原发癌引流途径中的肿瘤性血栓形成还是肝脏中的转移灶。