Hellerich U, Pollak S
Institut für Rechtsmedizin der Universität Freiburg/Br.
Arch Kriminol. 1997 Nov-Dec;200(5-6):159-66.
Cases of sudden death accompanied by impressive external bleeding may arouse suspicion of violence. On the other hand fatal hemorrhages from the respiratory tract can be caused by injuries as well as by diseases. In the age of successfully treated tuberculosis the majority of pulmonary hemorrhages is based on bronchogenic carcinomas. Examples of fatal bleeding from malignant tumours of the bronchus show the variety of morphological substrates giving rise to these hemorrhages: e.g. aneurysma-like dissection of pulmonary arteries infiltrated by bronchogenic carcinoma, leukocytoclastic destruction of vessel walls surrounded by tumour necrosis, and arrosion of small arteries in the tumour region which leads to massive hemorrhage owing to anticoagulant therapy.
伴有大量外出血的猝死病例可能会引发暴力致死的怀疑。另一方面，呼吸道的致命性出血可能由损伤以及疾病引起。在肺结核得到成功治疗的时代，大多数肺出血是由支气管源性癌所致。支气管恶性肿瘤致死性出血的例子显示了导致这些出血的多种形态学基础：例如，被支气管源性癌浸润的肺动脉呈动脉瘤样剥离，肿瘤坏死周围的血管壁发生白细胞破碎性破坏，以及肿瘤区域小动脉受侵蚀，由于抗凝治疗导致大量出血。
