Thrombendarteriitis pulmonalis carcinomatosa Ceelen: an immunohistological investigation

A 65-year-old woman died in sudden right heart failure caused by thrombendarteriitis pulmonalis carcinomatosa Ceelen 16 months after resection of a rectal carcinoma. Autopsy disclosed a complex picture of multiple tumour cell emboli in small pulmonary arteries associated with local thrombosis and thrombus-associated vessel wall reaction. This was characterized by movement of medial muscle cells into the thrombus. In addition, affected vessels showed a prominent perivascular tumour-related infiltration by lymphocytes which are identified immunohistochemically as CD3-reactive T-cells.