65 year old man who was a heavy smoker presented with chronic cough productive of yellowish sputum associated with fever and increasing breathlessness.
The lung shows extensive involvement of the bronchial tree and parenchyma by pale foci of caseous (cheesy appearing) necrosis. The upper lobe shows confluent necrosis with cavitation. On turning the specimen aroung, note the adhesions on the visceral pleural surface of the upper lobe.
Microscopy shows a lymph node involved by tuberculosis, with classical necrotizing granulomatous inflammation. Similar findings would be seen in the lung parenchyma.