Trachea, oesophagus, left lung, and heart portions
Object numberGC.10279
TitleTrachea, oesophagus, left lung, and heart portions
DescriptionPortions of trachea, left lung and oesophagus, and the heart, showing bronchial carcinoma.
From a male aged 40 years who was a prisoner of war in Japan from 1941-1945 and was in Nagasaki when the atomic bomb dropped.
While in Japan he had attacks of malaria and dysentery. After being released from prison in 1945 he weighed 6½ stones and it is stated that within four months his weight rose to 17 stones. He then had two attacks of pleurisy followed by a persistent cough.
Four years after the pleurisy he had haemoptysis. Radiographs and bronchoscopic biopsy revealed bronchial carcinoma. The condition was considered inoperable and he was treated with nitrogen mustard which appeared to give some improvement.
Six months later he developed symptoms and signs of a cerebral neoplasm and a large tumour, which proved to be secondary to the bronchial carcinoma, which was removed from the right cerebellum. A week later death occurred as a result of wound sepsis.
At post mortem the body was extremely emaciated and looked older than that of a man aged 40. The right pleural sac contained no fluid and was free from adhesions. On the left side there were old adhesions, particularly over the posterior aspect of the lung and also some evidence of recent pleurisy, but no free fluid. The larynx and trachea were inflamed and filled with copious mucopurulent debris. The left main bronchus was narrowed and its wall irregularly infiltrated by firm, greyish-white neoplastic tissue which gave the inner surface of the bronchus a coarsely granular appearance, while externally the tumour was continuous with a small mass of similar tissue lying below the bifurcation of the trachea and adherent to the oesophagus posteriorly. At this level a fistula was present between the left main bronchus and the oesophagus. The tumour tissue extended along the left lower lobe bronchus into the middle of the lobe and the affected bronchial walls were acutely inflamed, narrowed and filled with muco-pus. Malignant glands were found below the bifurcation of the trachea and at a slightly higher level between the trachea and the oesophagus.
The preparation consists of the lower part of the trachea and. the left bronchus which have been opened from behind; the anterior portion of the left lung; a segment of adherent oesophagus also opened posteriorly; the heart and some of the main vessels.
The inner surface of the left bronchus shows a raised irregular and congested thickening which obscures the cartilaginous rings and narrows the lumen. The tumour has extended through the adjacent oesophagus and given rise to a broncho-oesophageal fistula. A portion of tissue in the region of the lower part of the fistula has been removed for histological investigation. There is a continuous extension of the tumour to the glands in the angle between the main bronchus and. also peripherally along the main left lower lobe bronchus to near the middle of the lobe. This bronchus is seen in section to have a narrowed nd irregular lumen, with a thick layer of pale tumour tissue around. The lung is congested and oedematous and in the lower lobe there is an area of well-established bronchopneumonia.
Photomicrographs of the tumour show a well differentiated squamous-cell carcinoma.
Production periodTwentieth century
Object nameLUNG, left, OESOPHAGUS and TRACHEA, HEART
Object categoryAnatomical, specimen
Dimensions
- Jar Height: 25 cm
Width: 22 cm
Depth: 6.5 cm