65-year-old male, recurrent pleural effusion, malignant cells in aspirate cytology.
Respiratory failure. Autopsy shows carcinoma of the tail of the pancreas. Autopsy specimen.
- Thickened pleura/ broadened interlobar septum
- Bronchoalveolar carcinoma with infiltration of the pleura can not be morphologically distinguished from metastases of an extrapulmonary carcinoma. The diagnosis can only be made in conjunction with history or other autopsy findings.
- Tumour in pleura and neighbouring lung
- There is a glandular tumour of middle-sized cuboidal cells in the pleura.
- The tumour is growing along the interalveolar septa in the lung leading to the alveoli, which are lined by large cylindrical, relatively polymorphic tumour cells.
- Bleeding, oedema and anthracosis of the lung
Differential diagnosis: a mesothelioma of epithelial type can look like the intrapleural components of the tumour. The subsequently done CEA reaction was positive: This is not consistent with mesothelioma and points more towards metastases.