Macroscopy: 1. Labelled "Left upper lobe resection". Left upper lobectomy specimen, 140 x 76 x 43 mm, 145 g. At the bronchial resection margin, inked green, there is a 31 x 26 x 23 mm tumour that is pale green and uniform. The tumour distends and fills the bronchial airways, and protrudes out of the bronchial resection margin. The closest point of tethering is 2 mm from the resection margin. The tumour is less than 1 mm from the lung parenchymal resection margin. No invasion of parenchyma is demonstrated. The tumour obstructs the left upper lobe bronchus at the hilum, with bronchiectasis of the inferior segmental airways. The background lung is brown, spongy and soft.
2. Labelled "Station 7 node". Yellow, fatty tissue, 21 x 9 x 8 mm, containing one black lymph node, 12 mm.
Tumour is present within the lumen of the left upper lobe bronchus at the resection margin, however, the point of tumour attachment to the bronchial wall is 2 mm clear of the resection margin.
Microscopy: 1. The lumen of the left upper lobe bronchus. The tumour is composed of a trabecular proliferation of relatively uniform cells that have round nuclei, stippled chromatin, and a moderate amount of granular cytoplasm. No mitotic figures are seen (0 per 10 HPF), and there is no tumour necrosis. No lymphovascular or perineural invasion seen. Distal to the tumour, there is bronchial dilation with inspissation of mucus. Away from the tumour, the alveolar architecture is preserved with small numbers of intra-alveolar macrophages.
2. Sections show lymph node with reactive histiocytosis and mild anthracosis. There is no malignancy.