[Non-bacterial thrombotic endocarditis. Autopsy study, clinico-pathological correlations (author's transl)].

During the course of 6 000 autopsies, the number of cases of non-bacterial thrombotic endocarditis discovered was 130 (absolute frequency of 2.1 p. cent). Frequency was highest among patients with cancer, of which there were many in this series (4 p. cent of 2 287 autopsies). In 83 p. cent of cases, therefore, the endocarditis was of paraneoplasic origin, usually associated with adenocarcinomas, especially those of bronchopulmonary, pancreatic or gastric origin. Less frequently, they developed during the course of shock or debilitating affections. The endocarditis lesion consists of a coagulated fibrin and platelet mass without microbial germs, located electively on the mitral and aortal valves. Emboli are a frequent consequence (47 p. cent of cases) affecting primarily the central nervous system, the kidneys, spleen, and hart. Ischemic effects of these latter, observed in 75 p. cent of cases, are generally latent. In some cases they produce clinical manifestations, and they may be the cause of death from a cerebral or myocardial infarct. Pathological examination demonstrates the frequent association of these endocarditis lesions with often multiple vascular thromboses, and disseminated intravascular coagulation affecting the same regions as the emboli. This emphasizes the major role of coagulation disorders in their genesis.