like a napkin rings you know who actually produce narrowing below min obviously is infiltrated the muscle of the wall that would produce a change in bal habits it will produce frank in the schools is close enough to the unicef if it bleeds can come out blood that's referred to he met okie xia ichi ohmae tito cdh_ lindsayolives came at a meaning blood his ears a wonderful greek word for me to go potty over the american uses frank blood unit in the school which may be that in again people deny this is a law that hemorrhoids and thereby preparation h and stick it up there for however long before they finally come in the important thing is is will also point out this afternoon is be the survival of the prognosis is stage related farzad penetrate through the ball wall is it in the regional lymph nodes and so forth uh... these are the important factors all right couple of smokers things you can see about fifty packages of and that long here is a massive obstructing bronchus here this is the dilated bronchus and full of newco kurland exudate that's the tumor right there and this patient presented or we probably had a cough but all smoker's cough uh... presented with repeated pneumonia kept coming with episodes of pneumonia who's always in the same place and they finally tumbled to the fact that we always have obstruct must have obstructive lesion there and there it was not leave bronchus is line by a glandular type of epithelium so there are adamo carcinomas and one notoriously there can be metalplaza xia of the broncos that goes on to display not only not a place of the displays human cancer and many of these parts qua must sell carcinomas so there is a relatively small one that produced repeated bouts of pneumonia there's a larger one just to show you what they could look like when they really get out of hand here's an interesting one uh... close up here trachea coming down here bronchus hier bronchus here you see this little thing this was a sway with cell carcinoma and you say well why didn't they uh... simply doing norman actually take off the bronchus here you can live with one long doing it right here this is an autopsy specimens and actually this thing that looks small here had gone through the back of the bronchus this is all neoplasm kind of in case the heartbeat was hopeless from from from the get go swimmin cell carcinoma sestalo market was the benign one of my smooth surfaces inside this this will line when i see you had a feeling of here's the malignant counterpart you can see the steiner's than other ovarian neoplasm it's mulligan and so we call it sister i don't know carcinoma masses there than normal disassemble carcinoma the thing and then would immediately took us to say this isn't just a simple system nama is a surface is no longer smooth like this everywhere this guy very furry looking growth all over the surface and the bubbles inside ourselves neoplasm growing from the lining of the trouble in other words the many of you can see some bubbles so there are some cystic spaces but many of the previously cystic spaces are filled with his rapidly growing neoplasm so this is sister adamo carcinoma i don't have an illustration of it but you can imagine papillary tumor being eight papillary carcinoma greta papilloma or papillary carcinoma so learn to to handle these uh... the moment but sure here as i say quite quite played by reflex 