PMC9440277_01
Brain MRI showed symmetric increased fluid-attenuated inversion recovery signals in the basal ganglia and medial temporal lobes.
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Figure 1 ).
Full-body CT revealed a mass in the right hilar region.
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Full-body CT revealed a mass in the right hilar region, consistent with a diagnosis of SCLC ( Figure 2 ). Fluorine-18 fluorodeoxyglucose [(18)F-FDG]-positron emission tomography (PET) revealed increased uptake of tracer in the right hilum but no apparent distant metastasis.
Microscopic images for the globus pallidus (A, C) and lung tumor (B). Blue and orange squares indicate perivascular regions and parenchyma with neurons, respectively. Bars, 50 mum. (D) RT-PCR using total RNA derived from the indicated organs of the patient (D). GAPDH, glyceraldehyde 3-phosphate dehydrogenase; GrB, granzyme B; GRIN1, glutamate ionotropic receptor N-methyl-D-aspartate type subunit 1; Synapt, Synaptophysin; TIA-1, T-cell intracytoplasmic antigen-1.
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Activated neuronophagic cytotoxic T cells (CTL) that were positive for CD3, CD8, TIA-1, and granzyme B were diffusely spread throughout the brain parenchyma, whereas CD20-positive B cells were localized in the perivascular regions ( Figures 3A, C ). The right lung tumor was diagnosed pathologically as a neuroendocrine marker-positive SCLC with scant cytoplasm and salt-and-pepper nuclei ( Figure 3B ). Furthermore, we conducted quantitative polymerase chain reaction (qPCR) which revealed GluN1 gene expression in the SCLC tissue ( Figure 3D ).