Unusual presentation of pulmonary infarction

A somewhat unusual presentation of pulmonary infarction is reported in two young adults. In the first there were no preceding precipitating factors such as prolonged recumbency, recent operation, or venous thrombosis, so thoracotomy with excision of the diseased area was performed because the diagnosis was unknown. In the second patient the initial symptoms were classically those of acute pulmonary infarction, but the persistence of haemoptysis for six months thereafter accompanied by weight loss and the finding of malignant cells in the sputum prompted surgical intervention. Histological examination confirmed pulmonary infarction but with surrounding epithelialization closely resembling pre-malignant metaplasia. This we regard as strongly suspicious of an early phase of development of a scar cancer.