SYSTEMIC EMBOLISM IN A RENAL-TRANSPLANT P ATIENT - ECHOCARDIOGRAPHIC DIAGNOSIS OF BRONCHIAL-CARCINOMA WITH INTRACARDIAC INVASION

A 45 year old female renal transplant patient was admitted for subacut e ischaemia of a lower limb. Echocardiography was performed and showed the presence of bronchial carcinoma with intracardiac invasion. The t umour was confirmed by thoracic computerised tomography and by broncho scopy. Histological investigation of bronchial biopsies and of the art erial embolism extracted at surgery showed large cell malignant diseas e. The tumour partially responded to chemotherapy and the patient surv ived for 5 months. Extension of a bronchial carcinoma to the left atri um is a classical complication in autopsy reports but rarely a source of systemic embolism. Echocardiographic diagnosis of this condition is very rare. The incidence of malignant diseases is higher in renal tra nsplant patients than in the general population but this has not been Verified for bronchial carcinoma. Echocardiography played an essential role in this case, detecting the tumour and its extension, indicating a poor prognosis and guiding treatment.