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Background. In a patient with suspicious synchronous multiple tumours, there are limited possibilities for effective therapy. Therefore, the decision for invasive diagnostics and precise staging of tumours is questionable, especially in elderly patients suitable only for symptomatic therapy. Case report. A 78-year-old man with hypertension and angina pectoris was admitted to the hospital due to syncope. Two primary lung tumours and a kidney tumour were detected by imaging investigation. The patient refused invasive diagnostics and left the hospital. After 19 months he was readmitted in an impaired clinical condition and subsequently died of bronchopneumonia. The autopsy revealed squamous cell carcinoma of the right upper lobe with metastases to regional lymph nodes and to the brain, small-cell carcinoma of the left upper lobe with metastases to regional lymph nodes and to the spleen, and clear-cell kidney carcinoma with multiple metastases to the lungs. All tumours were necrotizing, and therefore we assumed that any attempt at specific therapy would have been ineffective. Conclusions. In an elderly patient with advanced lung tumors and suspicious synchronous triple cancers, the "wait and see" option can be suitable.

Izhodišče: Bolezen covid-19  povzroča difuzno alveolno okvaro, povezano z visoko stopnjo umrljivosti. Namen analize umrlih bolnikov, okuženih z virusom SARS-CoV-2, je oceniti histopatološke spremembe v pljučih kot glavnem tarčnem organu pri tej okužbi. Metode: Opravili smo delne obdukcije bolnikov s covidom-19, ki so se zdravili na Univerzitetni kliniki za pljučne bolezni in alergijo Golnik. Ocenjevali smo izraženost različnih histopatoloških sprememb v pljučih umrlih. Z imunohistokemično metodo smo dokazovali prisotnost virusa SARS-CoV-2 v vzorcih pljuč. Rezultati: V pljučih so izstopali znaki akutne alveolne okvare s tvorbo hialinih membran, intersticijskim in alveolnim edemom ter fibrinsko eksudacijo v alveolih. Spremljajoča vnetna reakcija je bila blago do zmerno izražena. Pri nekaterih bolnikih je bila alveolna okvara že v fazi organizacije, vendar brez prisotne fibroze. Pri vseh bolnikih smo našli citopatsko spremenjen alveolni epitel kot znak virusne okužbe celic. V vzorcih pljuč vseh bolnikov smo dokazali prisotnost virusa. Zaključek: Bolezen covid-19 prizadene pljuča in povzroči difuzno alveolno okvaro, zaradi katere bolniki lahko umrejo. Obdukcija se je izkazala za pomembno tudi v svetu zaradi raziskovanja nove bolezni.

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