A portion of lung, cut to display multiple deposits of tumour up to 2.5 cm. in diameter. This is the
classical “canon-ball” pattern of metastasis. The cut surface of the specimen also displays hilar
lymph nodes infiltrated by tumour.
This man was admitted to hospital in November 1975 with increasing shortness of breath,
decreased exercise tolerance, pleuritic pain and right-sided weakness. Previously, he had had
recurrent attacks of bronchitis, and he had been a heavy smoker for 40 years. Examination showed
spider naevi, a right pleural effusion, enlarged supra-clavicular lymph nodes, an enlarged liver, and
left hemiplegia. Death occurred approximately 1 week after admission. At autopsy, a
poorly-differentiated squamous cell carcinoma of the right upper lobe bronchus was demonstrated,
with multiple metastases in the lungs, local lymph nodes and kidney.