Intrabronchial metastases fromrenal carcinoma with recurrent tumourexpectoration

Threepatients are described whopresented totheir doctors witha history of coughing up pieces oftissue. Thesetooktheformoflarge bronchial castsandconsisted of intrabronchial deposits ofclear cell carcinoma. Inone patient thepulmonary symptomspre- cededthefinding ofa primary renal carcinoma byfouryears.Theother twopatients had undergone nephrectomy forrenal carcinoma 13andfouryearspreviously. Expectoration of intrabronchial tumourshould alert thephysician tothepossibility ofmetastasis fromclear cell carcinoma ofthekidney. Inthoracic medical practice itisrareforapatient topresent hisdoctor withthematerial fromwhich ahistological diagnosis canbemadewithout the needtosubmit tobiopsy. We describe three such patients, allofwhomexpectorated tumourtissue andallofwhom hadintrabronchial metastasis fromrenal carcinoma. Casereports PATIENT 1 A previously healthy 34-year-old man wasad- mitted tohospital inJuly1969withright-sided pleurisy, cough, anddyspnoea after aninfluenza- likeillness. On threeseparate occasions hehad expectorated piecesof "pinkmeatytissue" approximately 1cm long. Hischestradiograph showedasmall right pleural effusion andopacities intherightlowerzonethoughttorepresent