Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1995 Feb;50(2):160–164. doi: 10.1136/thx.50.2.160

Incidence of pulmonary thromboembolism, infarction and haemorrhage in disseminated intravascular coagulation: a necroscopic analysis.

Y Katsumura 1, K Ohtsubo 1
PMCID: PMC473913  PMID: 7701455

Abstract

BACKGROUND--The pathological features of the lung in disseminated intravascular coagulation (DIC) have not been established. This study was carried out on lungs taken at necropsy to examine the incidence and extent of thromboembolism, infarction, and haemorrhage. METHODS--The subjects were 87 patients whose illnesses were complicated by DIC and 64 patients who showed no abnormalities of blood coagulation in their terminal illness. The lungs were fixed by intrabronchial infusion of 10% formalin, cut into 5 mm thick slices, and each cut surface was carefully examined for macroscopic thromboembolism, infarction, and haemorrhage. Five tissue blocks per case were taken for quantitative analysis of microscopic thromboembolism. RESULTS--In the control group macroscopic thromboembolism was identified in 20 cases (31.3%), infarction in one, and haemorrhage also in one. Moreover, fibrin thrombosis was seen in 13 cases (20.3%) and microthromboembolism in 24 (37.5%). Of the 87 patients with DIC, thromboembolism was found in 51 cases (58.6%), infarction in six, haemorrhage in 14, microscopic fibrin thrombosis in 43 (49.4%), and microthromboembolism in 45 (51.7%). Macroscopic thromboembolism, haemorrhage, and fibrin thrombosis were found more often in the patients with DIC. CONCLUSIONS--In addition to fibrin thrombosis, macroscopic thromboembolism and haemorrhage were the main pathological findings in the lungs of patients dying with DIC. The frequency of pulmonary infarction increased in proportion to the frequency of thromboembolism.

Full text

PDF
160

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ansari A. Acute and chronic pulmonary thromboembolism: current perspectives. Part II: Etiology, pathology, pathogenesis, and pathophysiology. Clin Cardiol. 1986 Sep;9(9):449–456. doi: 10.1002/clc.4960090912. [DOI] [PubMed] [Google Scholar]
  2. Bagge L., Haglund O., Wallin R., Borg T., Modig J. Differences in coagulation and fibrinolysis after traumatic and septic shock in man. Scand J Clin Lab Invest. 1989 Feb;49(1):63–72. doi: 10.3109/00365518909089079. [DOI] [PubMed] [Google Scholar]
  3. Blaisdell F. W., Lim R. C., Jr, Amberg J. R., Choy S. H., Hall A. D., Thomas A. N. Pulmonary microembolism. A cause of morbidity and death after major vascular surgery. Arch Surg. 1966 Nov;93(5):776–786. doi: 10.1001/archsurg.1966.01330050080012. [DOI] [PubMed] [Google Scholar]
  4. Blaisdell F. W., Stallone R. J. The mechanism of pulmonary damage following traumatic shock. Surg Gynecol Obstet. 1970 Jan;130(1):15–22. [PubMed] [Google Scholar]
  5. Bone R. C., Francis P. B., Pierce A. K. Intravascular coagulation associated with the adult respiratory distress syndrome. Am J Med. 1976 Nov;61(5):585–589. doi: 10.1016/0002-9343(76)90135-2. [DOI] [PubMed] [Google Scholar]
  6. Colman R. W., Robboy S. J., Minna J. D. Disseminated intravascular coagulation (DIC): an approach. Am J Med. 1972 May;52(5):679–689. doi: 10.1016/0002-9343(72)90058-7. [DOI] [PubMed] [Google Scholar]
  7. Coon W. W. Risk factors in pulmonary embolism. Surg Gynecol Obstet. 1976 Sep;143(3):385–390. [PubMed] [Google Scholar]
  8. FREIMAN D. G., SUYEMOTO J., WESSLER S. FREQUENCY OF PULMONARY THROMBOEMBOLISM IN MAN. N Engl J Med. 1965 Jun 17;272:1278–1280. doi: 10.1056/NEJM196506172722406. [DOI] [PubMed] [Google Scholar]
  9. Fourrier F., Chopin C., Goudemand J., Hendrycx S., Caron C., Rime A., Marey A., Lestavel P. Septic shock, multiple organ failure, and disseminated intravascular coagulation. Compared patterns of antithrombin III, protein C, and protein S deficiencies. Chest. 1992 Mar;101(3):816–823. doi: 10.1378/chest.101.3.816. [DOI] [PubMed] [Google Scholar]
  10. KORN D., GORE I., BLENKE A., COLLINS D. P. Pulmonary arterial bands and webs: an unrecognized manifestation of organized pulmonary emboli. Am J Pathol. 1962 Feb;40:129–151. [PMC free article] [PubMed] [Google Scholar]
  11. Kim H. S., Suzuki M., Lie J. T., Titus J. L. Clinically unsuspected disseminated intravascular coagulation (DIC): an autopsy survey. Am J Clin Pathol. 1976 Jul;66(1):31–39. doi: 10.1093/ajcp/66.1.31. [DOI] [PubMed] [Google Scholar]
  12. Morrell M. T., Dunnill M. S. The post-mortem incdence of pulmonary embolism in a hospital population. Br J Surg. 1968 May;55(5):347–352. doi: 10.1002/bjs.1800550506. [DOI] [PubMed] [Google Scholar]
  13. Morrell M. T. The incidence of pulmonary embolism in the elderly. Geriatrics. 1970 Aug;25(8):138–passim. [PubMed] [Google Scholar]
  14. Robboy S. J., Major M. C., Colman R. W., Minna J. D. Pathology of disseminated intravascular coagulation (DIC). Analysis of 26 cases. Hum Pathol. 1972 Sep;3(3):327–343. doi: 10.1016/s0046-8177(72)80034-0. [DOI] [PubMed] [Google Scholar]
  15. Robboy S. J., Minna J. D., Colman R. W., Birndorf N. I., Lopas H. Pulmonary hemorrhage syndrome as a manifestation of disseminated intravascular coagulation: analysis of ten cases. Chest. 1973 May;63(5):718–721. doi: 10.1378/chest.63.5.718. [DOI] [PubMed] [Google Scholar]
  16. Rodvien R. Hematologic observations made in patients with acute respiratory distress syndrome in the cooperative ECMO project. Artif Organs. 1978 Feb;2(1):12–18. doi: 10.1111/j.1525-1594.1978.tb00998.x. [DOI] [PubMed] [Google Scholar]
  17. SMITH G. T., DAMMIN G. J., DEXTER L. POSTMORTEM ARTERIOGRAPHIC STUDIES OF THE HUMAN LUNG IN PULMONARY EMBOLIZATION. JAMA. 1964 Apr 13;188:143–151. doi: 10.1001/jama.1964.03060280045011. [DOI] [PubMed] [Google Scholar]
  18. Schneider R. C., Zapol W. M., Carvalho A. C. Platelet consumption and sequestration in severe acute respiratory failure. Am Rev Respir Dis. 1980 Sep;122(3):445–451. doi: 10.1164/arrd.1980.122.3.445. [DOI] [PubMed] [Google Scholar]
  19. Tomashefski J. F., Jr, Davies P., Boggis C., Greene R., Zapol W. M., Reid L. M. The pulmonary vascular lesions of the adult respiratory distress syndrome. Am J Pathol. 1983 Jul;112(1):112–126. [PMC free article] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES