NECROSIS OF TUMOUR CELLS RELATED TO CIRCULATORY INSUFFICIENCY IN PULMONARY TUMOUR EMBOLISM

Postmortem examination of a woman with epidermoid carcinoma of the cervix uteri revealed numerous tumour emboli in small pulmonary arteries. Some arteries were occluded by tumour cells showing extensive necrosis in the central part of the lumen. In many arteries groups of tumour cells were present along the vessel wall while the central area was occupied by a partially organized thrombus or connective tissue. The tumour cells looked viable near the vessel wall and close to the intravascular connective tissue, while necrotic cells were often found in the centre of the groups of tumour cells. The intravascular tumour growth was poor in arteries with extensive perivascular tumour growth. The tumour grew better in perivascular lymphatics than in the arteries. It was concluded that the observations made in this case supported the hypothesis that necrosis of tumour cells in pulmonary tumour emboli was due, in part at least, to nutritional insufficiency caused by circulatory disturbances produced by the tumour itself.