LUNG - Secondary carcinoma

The cut surface of the inflated right lung shows a prominent trabecular pattern in the upper and middle lobes, with consolidation in the lower lobe, where there is also at least one, rather poorly-defined, nodule approximately 1 cm. in diameter. The pleural surface shows a diffuse thickening towards the apex, with multiple minute nodules of thickened pleura in the other parts of the lung. The appearances suggest secondary tumour with marked lymphatic involvement.
This man had a past history of gastric carcinoma with gastrectomy 4 years before his death, and rectal carcinoma with anterior resection 3 years before his death. A chest X-ray following a short history of increasing shortness of breath showed a fine nodularity throughout the lungfields, and linear opacities consistent with fibrosis or lymphangitis. An open lung biopsy was attemped, but he collapsed and this was not carried out. The scalene lymph nodes showed metastatic adenocarcinoma, consistent with an origin from stomach. Microscopically, tumour was demonstrated in the lung and pleura, but not apparently elsewhere.