Macroscopic and microscopic findings of the heart. A: cut surface of the heart. The heart weighed 780 g and showed numerous metastatic nodules and diffuse myocardial thickening, simulating hypertrophic cardiomyopathy. B: metastatic tumor cells invaded the myocardium with stromal edema (HE). C: immunohistochemical analysis for D2-40 demonstrated severe lymphatic infiltration of tumor cells.