FIGURE 11.

25-year-old female patient with gastric carcinoma and severe pulmonary hypertension. Autopsy findings. a) Muscular-type pulmonary arteries display irregular/eccentric intimal fibrosis; the arterial lumen contains fresh fibrinous clot material (arrows) intermingled with carcinoma cells (arrowheads) and scattered leucocytes; note the adjacent bronchioles to the upper right. Magnification: ×40. b) Similar clots and tumour cells are found in small pulmonary arterioles, with complete occlusion (arrows). Magnification: ×100. Case provided by Teodora Radonic and Esther Nossent (UMC, Amsterdam, the Netherlands).