23994              DIFFUSE ALVEOLAR-CELL CARCINOMA

The patient was a man aged 49, a self-employed painter who had been a heavy smoker until 2 weeks before his last admission, when he developed shortness of breath, gradually worsening with moderate nocturnal dyspnoea, mild orthopnoea, cough and white sputum.  Chest X-ray showed extensive diffuse infiltration with rounded opacities suggesting a metastatic lesion.  The sputum was positive for malignant cells.  Because dyspnoea at rest became progressively more marked he was transferred to the intensive care unit and given 100% oxygen to breathe.  He died suddenly on the 5th day.  At postmortem there was extensive bilateral pulmonary infiltration throughout the entire lung.  This is shown in the specimen in the form of small threads and strands and tiny nodules coalescing in some places to form larger masses up to a few mms in diameter.  Neoplastic collars are visible surrounding some of the medium-sized vessels.  Lymphatic infiltration is conspicuous in the subpleural lymphatic invasion is prominent.

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