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Specimen 1358.19 - Carcinoma of lung

Spiel: A man aged 59 years sought medical advice for gradually worsening shortness of breath, cough, loss of weight, and bloodstained sputum, which had been present for several weeks. X-ray of his lungs showed a lesion at the hilum of the lung, suggestive of a cancer, and this was confirmed by bronchoscopy and examination of a sample of the tumour. The cancer was considered to be inoperable, and he was treated with radiotherapy without a good response. He gradually became wasted, and died. This specimen of the right lung shows an irregular, light-grey tumour arising from the right main bronchus. The main part of the tumour is infiltrating into the surrounding lung tissue, and also extends upwards to involve the lowe rpart of the trachea (wind pipe). At one point, the tumour is seen to project into the inside of the bronchus. The lymph nodes area extensively involved due to invasion by the tumour, and form a fused mass, which merges with the primary lesion. This is compressing the pulmonary vessels. The top of the lung contains two small red infarcts (areas of tissue death). The pleura oerlying the upper lobe is markedly thickened.

Anatomical description

Specimen of the week - Carcinoma of lung

Name the organ present in this specimen: Rt lung

Macroscopic pathology

Describe the lesion/s that you can see in the specimen.

Pathogenesis

What pathological process/es is/are evident in this specimen? Describe the likely series of events that led to these appearances.

Clinical manifestations

List the likely clinical manifestations in this case.

Complications

What complications might have arisen from the lesion shown in the specimen and how might they manifest clinically?