16538              CARCINOMA OF MIDDLE LOBE BRONCHUS WITH COLLAPSE

The patient was a man aged 60.  Four months previously X-ray had shown shadows suggestive of right middle lobe tumour with collapse.  Malignant cells were found in the sputum and biopsy showed a poorly differentiated squamous cell carcinoma of the right main bronchus.  He had had a chronic cough and he was a heavy smoker.  Five weeks intensive radiotherapy was given and the right lung was then resected.  He died a few days after the operation and at postmortem no metastases were found elsewhere in the body.

The specimen is of this lung sectioned to show a small primary carcinoma obstructing the middle lobe bronchus.  The lobe distal to the tumour shows marked fibrotic collapse and some neoplastic infiltration.  Bronchi in this collapsed zone show saccular bronchiectasis and contain thick mucopurulent exudate.  There are some small patches of lipoid pneumonitis at the tip of the lobe.  The interlobar septa surrounding the middle lobe are greatly thickened.  There is congestion and partial collapse of the lateral basal segment of the lower lobe.  The upper lobe shows moderate panlobular emphysema with increase in the interlobular septa.