4144                TRACTION DIVERTICULUM OF LOWER OESOPHAGUS

The patient was a man aged 85 who died of acute bronchopneumonia.  At postmortem there was a right apical pulmonary scar and the glands about the bifurcation of the trachea and the lower oesophagus were enlarged, caseous and calcified.  There was acute bacterial endocarditis of the mitral valve.

The specimen consists of the lower 10 cms of the oesophagus and the cardiac portion of the stomach.  An ovoid opening 2 cms x 4 cms is present in the terminal oesophagus on its left posterior aspect.  This leads to the elongated sac of an upwardly directed diverticulum which measures 5 cms in length and 2.5 cm in width.  The reverse of the specimen shows a mass of partly caseous and partly calcified lymph glands matted together in the region of the neck of the diverticulum.  Another (bisected) calcified gland 1 cm in length lies near the tip of the sac on its anterior aspect.  Some leukoplakia is visible in the mucosa of the oesophagus on the medial lip of the diverticular orifice.