PMC3187935_01
Chest X-ray findings. A, B, C, and D show chest X-rays taken in 2006, 2007, 2008, and 2009, respectively. These X-rays revealed a lesion in the right lower lung field, which formed a cavity and enlarged over time.
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F1
He was found to have a small shadow in the right lower lung field on chest X-ray in 2006, and was thereafter followed-up at another hospital (Figure 1A). Chest X-ray in 2007 revealed a cavitating shadow at the same site (Figure 1B). A chest X-ray in 2008 showed thickening of the cavity wall, and that in 2009 revealed the tendency of the entire cavity shadow to enlarge (Figure 1C, D).
Radiologic and macroscopic findings. A, Computed tomography showed a cavitary shadow in the basal segment of the right lung, and the cavity contained lung tissue. B, Macroscopically, the cavity was torn in some areas, and lung tissue and blood vessels could be observed in the cavity.
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F2
Computed tomography showed an inhomogeneous thickening of the cavity wall and spiculation from the tumor margin, as well as the presence of lung structures in the cavity (Figure 2A). Gross examination of the tumor showed a cavity whose wall was grayish-white, uneven in thickness, and was torn in some areas (Figure 2B).
Pathological findings. A-B, The cavity was lined with dilated bronchi (arrow) and tumor cells (arrowhead). The extensive area of collapsed scars was observed around the dilated bronchi. C-D, The portion of the cavity wall lined with normal ciliated bronchial epithelium. Normal bronchial cartilage was observed in the vicinity. E-F, The portion of the cavity lined by tumor tissue. There was collapsed lung in the tumor (A, C, E, Hematoxylin and eosin staining; B, D, F, Elastica-van Gieson staining).
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F3
The internal surface of the cavity wall was lined with dilated bronchi and adenocarcinoma cells, and the extensive area of collapsed scars was observed around the dilated bronchi (Figure 3A-F).