LUNG - Anaplastic tumour

The specimen shows both the upper and lower lobes of the right lung; in the lower lobe there is a circumscribed tumour mass in which there are numerous areas of necrosis. The tumour extends to the surface of the lung and the lung surrounding is compressed and collapsed. The histology of the lesion is that of an anaplastic tumour and there is uncertainty as to its origin.
This man presented at the age of 63 with an 8 to 10 week history of right-sided chest pain exacerbated by coughing and slowly increasing shortness of breath; he had a productive cough. He had a past history of rheumatoid arthritis. At operation the chest wall was involved and several ribs were removed together with the lung. Neither anatomically nor histologically was it possible to say whether this was a primary undifferentiated carcinoma of the lung or an undifferentiated sarcoma arising from the chest wall. At autopsy, four days postoperatively, no primary tumour was identified.