Cervicothoracic ganglionectomy, trunk resection and ramisectomy by the posterior intrathoracic approach

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1. 1. This patient presented progressive involvement of all of the superficial lymph nodes. 2. 2. Obstructive phenomena were present. About 12,000 c.c. of chylous fluid were removed from the chest at various times. 3. 3. At autopsy we found enlarged mediastinal lymph nodes which obstructed the thoracic duct. The spleen was markedly enlarged and presented the appearance of a cross section of a Bologna sausage. 4. 4. The clinical syndrome was confused with Hodgkin's disease. 5. 5. The difficulties in diagnosis are evidenced by the differences in opinion expressed by the pathologists who have examined the specimens.