VASCULAR INTIMAL CARCINOMATOSIS - AN AUTOPSY CASE OF UNUSUAL FORM OF PULMONARY METASTASIS OF TRANSITIONAL-CELL CARCINOMA

A 44-year-old woman with an unusual form of pulmonary metastasis is de scribed. She presented with pulmonary thrombosis and clinical signs of disseminated intravascular coagulation (DIG) and died of cerebral hem orrhage. The autopsy study revealed transitional cell carcinoma of the left renal pelvis with pulmonary thrombosis in the large arteries. Th e intima of the vessels were intact on gross inspection except where t he thrombi adhered to. The thrombi contained no tumor cells. However, microscopic examination identified that the metastatic carcinoma diffu sely replaced the endothelium and proliferated on to the intimal surfa ce without invasion of the wall and metastatic nodules in the parenchy ma. Other examined organs had neither primary nor metastatic tumors, e xcept for microscopic metastasis to the inferior vena cava. To date, t his pattern of metastasis has not been noted in previous literature. T his condition was designated as being vascular intimal carcinomatosis because of its characteristic manner of tumor proliferation on vascula r intima.