Gross appearance: Four lymph nodes were submitted for frozen section. One interlobar node showed metastatic carcinoma. The right upper lobe was then excised. It weighed 260 g and measured 13 x 12 x 6 cm. Before fixation, sections from the bronchial and vascular margins were taken. The pleura was puckered over a palpable, firm mass in the medial portion of the lobe. After distension with formalin via the bronchus and fixation, the lobe was sliced. A firm, tan tumor, 4 x 3.2 x 2.7 cm extended to the pleural surface. The surrounding lung parenchyma showed mild emphysema, subpleural bullae, and an apical scar. Three hilar lymph nodes accompanying the resected lung also contained tumor.

The circumscribed tumor is lobulated and includes some black pigmented stroma. Most of the tumor is a translucent tan with irregular opaque foci, which represent necrosis. A segmental bronchus is present at right edge. The yellow tissue at the upper left represents endogenous lipoid pneumonia adjacent to the tumor.


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Clinical summary Image 1

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Endogenous lipoid pneumonia