Case 114

Surgical Pathology Case



A 60-year-old Caucasian male. History of renal cell carcinoma diagnosed in 1999 and prostate cancer in 2002. Recently, a CT scan of the chest was suspicious for a left hilar mass and an MRI of the brain revealed a 6 mm lesion in the suprasellar area. He had become progressively weak and had lost over 10 pounds due to nausea and anorexia and was unable to rest at night due to his extreme polyuria and polydipsia. A left thoracetomy with wedge resection and excision of left pulmonary hilar mass were performed.



The lobectomy specimen measures 14.5 x 9.5 x 4.0 cm with bronchus measuring 2.0 x 1.2 x 1.0 cm. The specimen weighs 195 grams.  The cut surface reveals two expanding tumor nodules, one measuring 2.0 x 1.6 x 1.5 cm and the other measuring 2.0x 1.9 x 1.5 cm.  Both nodules are observed arising from the left upper lobe.   The tumors are firm, gray/white and mottled by soft yellowish/white necrotic foci. 


HE, 4

HE, 10


HE, 20

HE, 40


HE, 40

HE, 40


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Source: Department of Pathology, Creighton University Medical Center, Omaha, NE

Photo: Zenggang Pan

Discussion: Zenggang Pan