| Abstrakt: |
The authors discuss the variants of kidney carcinoma thrombus invasion of the major retroperitoneal veins, up to the right atrium, on basis of the literature data and their own findings during prosectorial (4) and clinical (7) practice. They emphasize that carcinoma may not only invade the large veins in the cardial direction in the blood flow but may also spread against the flow into the contralateral renal, hepatic, iliac, and other veins, which is illustrated by examples. Symptoms of cardiovascular insufficiency with venous congestion in the liver and lungs with the formation of red infarcts, the development of ascites and even with fibrous changes in the organs and insufficiency of their function came to the forefront in mild clinical signs of the main focus of affection. According to the clinical material, the incidence of thrombi in the inferior vena cava was 3.9%. All the thrombi in operated on patients were below the diaphragm and measured up to 11 cm in length. Histologically the thrombus consisted of formed elements of the blood, tumor cells (adenocarcinoma of light cells) which were inside it and fibrin which was outside. The thrombi grow slowly and undergo organization and vascularization. |
