MICROSCOPIC DESCRIPTION: 1. Sections of the lung show features of a moderately differentiated adenocarcinoma. It is 18mm in size. The tumour forms acinar structures (100%). The periphery shows lepidic pattern of spread for 1-2mm. The tumour cells have enlarged nuclei, prominent nucleoli and moderate amounts of eosinophilic cytoplasm. The tumour extends close to but not through the elastic layer of the visceral pleura. No evidence of lymphovascular invasion is seen. The tumour is completely excised. The tumour cells are TTF-1 positive. 2. Sections of the completion lobectomy show no residual tumour. The bronchial and vascular resection margins are uninvolved. 3 normal hilar lymph nodes are seen. The lung parenchyma is unremarkable. 3. 2 lymph nodes are identified with no evidence of tumour. 4. 1 lymph node is identified with no evidence of tumour. 5. 1 lymph node is identified with no evidence of tumour.
DIAGNOSIS: 1. Left upper lobe: Moderately differentiated adenocarcinoma. -18mm in maximum dimension. -No evidence of pleural invasion. -No evidence of lymphovascular invasion. -Tumour completely excised. 2. Left upper completion lobectomy: -No residual tumour seen. -Bronchial resection margin clear. -3 normal hilar lymph nodes present. 3. Hilar lymph node: 2 lymph nodes identified with no evidence of tumour. 4. Station 5: 1 lymph node identified with no evidence of tumour. 5. Station 11: 1 lymph node identified with no evidence of tumour.