44 year old man with gradual onset of intestinal obstruction associated with vomiting, abdominal pain and distension, as well as anaemia.
The small bowel wall shows patchy thickening by tan, homogenous tumour with paler areas of necrosis. The mesenteric border shows a mass of enlarged matted lymph nodes. The bowel mucosa is ulcerated and the lumen is narrowed. Correlate this appearance with his symptoms.