a 73 year old male who undergoes a resection for a high grad | Figure 1

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A 73 year old male who undergoes a resection for a high grade adenocarcinoma of lung origin. The specimen for review is the bronchial margin.

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61 y/o male 40 pack yr smoking hx. Presents w/ 25 lbs weight loss and cough.

sorry for my English! The patient was admitted with acute violation of cerebral circulation.

Ct chest with another view of lung #Adenocarcinoma

Here we have a lung lobectomy removed for a biopsy-proven Adenocarcinoma. This is the most common form of lung cancer and is seen in both smokers and non-smokers.\

• The first picture shows the medial aspect of the lung, where we can see the grouping of stapled bronchi, arteries, and veins. These all represent a surgical margin and must be assessed microscopically to ensure no tumor cells are present.
• If there ARE tumor cells at the margin, that means there are likely tumor cells still inside the patient at that site, an obvious problem when addressing reoccurrence.
• Second pic is the opposing side, showing a small bulge in the visceral pleura, which I have inked over in blue. Ink is important in helping the pathologist visualize true margins and important diagnostic surfaces.
• Lastly, we have the cut surface of the tumor. Classic appearance of lung adenocarcinoma — yellow-white, firm, and ill-defined.
• The blue arrow points to the pleural surface and you can see that the mass appears to push on but not actually involve the pleura.
• The white arrow shows a vessel which looks potentially involved by the tumor.
• Since we don’t have invasion of the visceral pleura (at least grossly), the T stage of this tumor will be mostly based on size. At 3.5 cm in greatest dimension, without invasion of the pleura or the main bronchus, this tumor will be staged as a T2a.
• Final TNM staging must take into account the status of the region lymph nodes (N) and any scans for distant metastases (M).