Gross Intravenous Extension of Carcinoma of the Lung

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THE search for findings of prognostic significance at the time of operation for neoplastic disease is a continuous one. One such finding is that of venous invasion by a malignant tumor. In specimens of cancer of the colon such a demonstration is limited to microscopic evidence, as the invaded veins are too small for gross dissection. Conversely, in specimens of renal carcinoma, the large size of the veins facilitates gross examination for neoplastic invasion. The veins in specimens of carcinoma of the lung also are of a size to permit gross examination, yet no record of such an examination has been found, although the possibility of carcinoma of the lung invading the veins has often been mentioned.

Initially, one of us (L. J. M.), while making a survey of the occurrence of neoplastic cells in blood draining from pulmonary neoplasms, noted a frequency of venous invasion by such tumors.1 Although our case material is too recent for us to be able to make an adequate statistical evaluation in regard to survival of patients, we have sufficient pathologic data to report the immediate findings.

Material and Methods

Between January 1, 1953, and October 1, 1955, 345 patients with bronchogenic carcinoma were examined at the Cleveland Clinic. Some form of pulmonary resection was later performed in 79 of those patients, 48 of whom underwent pneumonectomy and 31 of whom were treated with lobectomy.

The unfixed surgical specimens were examined using a technic different from the usual pathologic procedure. Instead of initially opening. . .



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