See also L123a
Specimen B contains bisected right and left kidneys, segments of liver and spleen and a portion of
enlarged lymph nodes removed from the small bowel mesentery. A strip of mesenteric fat is
attached to the nodes. All of the tissues show extensive infiltration by tumour. The tumour is solid
and pale with focal areas of necrosis. Multiple nodules of tumour are seen within the liver, the
majority of these contain foci of haemorrhage.
The patient, a 60-year-old man, had a past history of hypertension. He was a known
smoker who consumed 25 cigarettes a day. He was admitted with a four week history of anorexia,
weakness and weight loss, associated with intermittent dyspnoea. Chest x-ray showed an opacity
of the left hemithorax with elevation of the left diaphragm and the suggestion of a mass above and
behind the left hilum. He gradually deteriorated and died 19 days following admission. Histologic
examination of tissue taken from the primary site and from each of the metastases showed small
cell undifferentiated carcinoma.