22494              DIFFUSE BRONCHOGENIC CARCINOMA

This patient was a man aged 43.  Six months previously a bronchial carcinoma was discovered by routine chest X-ray.  The diagnosis was confirmed by scalene node biopsy.  He was treated with radiotherapy and later cyclophosphamide, but symptoms progressed to weight loss, anorexia, cough, haemoptysis and pain in the distribution of C5 on the left side of the neck.  At postmortem massive carcinoma in the left lung was found, together with involvement of lymph nodes in the mediastinum, the neck and para-aortic region.  There were also metastases in the body of C5 vertebra infiltrating the nerve root and a further metastasis in the body of L2 vertebra.

The specimen consists of the lungs and major air passages sectioned in the coronal plane and viewer from the front.  The left lung is small, firm, shrunken and airless and its substance is almost completely replaced by yellow friable tumour tissue which presents an almost pneumonic appearance.  Lymph nodes in the hilum of the left lung are also involved by tumour.  There is a small nodule of tumour measuring 1.5 x 0.5 cms in the substance of the right upper lobe.  The trachea and major air passages are acutely inflamed.  Histology shows a poorly differentiated squamous-cell carcinoma.