Pulmonary tumour embolism from squamous cell carcinoma of the oesophagus

Pulmonary tumour embolism and subacute "cor pulmonale" have been reported in association with tumours of different origins. Even though these features were first described in a patient with carcinoma of the oesophagus, the frequency and importance of oesophageal tumours as the source of pulmonary tumour embolism have not been studied. In the present investigation, the lungs of 16 autopsied patients with squamous cell carcinoma of the oesophagus were studied prospectively. The lungs were removed as a block and 15 sections (3 from each lobe) were analysed. Pulmonary tumour embolism was detected in 7 cases. The lymphatic vessels were involved in all of them, and were associated with arteries and arterioles in 2. 2 patients presented a classical picture of subacute cor pulmonale, and dyspnoea was present in 3 other cases. The present study permitted us to conclude that carcinomas of the oesophagus frequently evolve toward carcinomatous lymphangitis and that pulmonary tumour embolism should be included in the differential diagnosis of the dyspnoea presented by the patients.