CASE HISTORY

All the patient’s signs and symptoms were related to the intra-thoracic tumour. There was nothing to indicate the presence of any intestinal lesion.

PATHOLOGY

The specimen consists of a loop of jejunum and its attached mesentery taken at a level about 2 meters below the duodenum. There is a comparatively small, narrow tumour completely encircling the bowel. It is involving the whole thickness of the wall but has not fungated into the lumen to any extent, nor is there any ulceration. The tumour can be well seen lying just under the peritoneal coat. There is a chain of infiltrated lymph glands running along the mesentery to the tumour. At autopsy there was an extensive invasion of all the abdominal lymph glands and the appearances suggest a direct spread of tumour along the lymphatics to the bowel. This may possibly be related to the fact that the tumour, though small and narrow, completely encircles the gut.