[ Monash University ]

Museum of Pathology

METASTATIC DEPOSITS PANCREATIC LYMPH NODES WITH ACUTE HAEMORRHAGIC PANCREATITIS

METASTATIC DEPOSITS PANCREATIC LYMPH NODES WITH ACUTE HAEMORRHAGIC PANCREATITIS

Clinical History

This 84 year old male presented to hospital with a 6 months history of malaise, weight loss of 2 stone and a 4 week history of L. hypochondrial pain. A gastroscopy revealed a large malignant ulcer on the lesser curve. A palliative Polya gastrectomy was performed. Following surgery his health gradually declined and he died one year later after developing terminal bronchopneumonia.

Pathology

The specimen comprises a small section of normal gastric mucosa recognised by its rugal folds. On the posterior aspect a longitudinal section of abdominal aorta is seen with two branches, the coeliac trunk and the superior mesenteric artery. A horizontal section of pancreas with several focal areas of haemorrhage and necrosis is seen. Separating the pancreas from the superior mesenteric artery are several grossly enlarged lymph nodes varying in diameter from 2.5 to 6 cm. Most of the nodes are replaced by necrotic secondary carcinoma. Histology revealed lymph node metastases consistent with spread from a primary adenocarcinoma of stomach.