[Undiagnosed bronchus carcinomas as the cause of sudden and unexpected fatalities]

Cases of sudden death accompanied by impressive external bleeding may arouse suspicion of violence. On the other hand fatal hemorrhages from the respiratory tract can be caused by injuries as well as by diseases. In the age of successfully treated tuberculosis the majority of pulmonary hemorrhages is based on bronchogenic carcinomas. Examples of fatal bleeding from malignant tumours of the bronchus show the variety of morphological substrates giving rise to these hemorrhages: e.g. aneurysma-like dissection of pulmonary arteries infiltrated by bronchogenic carcinoma, leukocytoclastic destruction of vessel walls surrounded by tumour necrosis, and arrosion of small arteries in the tumour region which leads to massive hemorrhage owing to anticoagulant therapy.