Virtual Slidebox
Presented by the MGH Pathology Service

Clinical summary
76 y/o female, tracheal mass

Clinical summary
65 y/o female, lung mass

Clinical summary
61 y/o female, lung nodule

43 y/o male with a lung mass extending into a bronchus

69 y/o male with a lung mass. Subaortic lymph node.

54 y/o male with pulmonary nodules

81 y/o male with a history of prostate carcinoma and melanoma, now with a lung nodule.

38 y/o female with a history of osteosarcoma

70 y/o male with a history of bladder and prostate carcinoma, and sarcoma of the thigh.

47 y/o male with a lung mass

Clinical history:

82 y/o male, lung mass

Suggested frozen diagnosis:

“Metastatic adenocarcinoma”

Clinical issues:

Mediastinal node staging is often done immediately prior to a planned definitive surgical resection for pulmonary carcinoma. Involvement of N2 nodes (levels 1-9, beyond the visceral pleura of the lung) is usually a contraindication for lobectomy or pneumonectomy. Missing a metastasis in these nodes on frozen may result in a futile surgical procedure, and substantial unnecessary morbidity to the patient. Unlike isolated mediastinal lymphadenopathy (possible lymphoma workup), staging nodes should be frozen entirely.

Read more on Pulmonary adenocarcinoma, metastatic (mediastinal lymph node)…

61 y/o male with lung nodules and mediastinal lymphadenopathy. Bronchial biopsy

Clinical summary
64 y/o female, lung mass

Clinical summary
26 y/o male, lung nodules

63 y/o female with esophageal carcinoma, incidental lesion in right lung.

71 y/o female with history of follicular lymphoma and Richter’s tranformation to diffuse large cell lymphoma. Now with increased mediastinal lymphadenopathy.

36 y/o male with a mediastinal mass

69 y/o female smoker with SIADH. Lung mass and mediastinal lymphadenopathy on chest CT

66 y/o female with a lung mass

Clinical summary
73 y/o male, lung mass