PMC10331302_01
Chest computed tomography (CT) findings showing mucoid impaction-like tumor in the right lower lobe in 30 September 2022 (A-C). CT findings showing an enlarged tumor in 20 December 2022 at the time of referral (D-F). Coronal image of whole-body positron emission tomography (PET) revealed abnormal accumulation of 18F-labeled fluorodeoxyglucose (FDG) in the right lower tumor and hilar/mediastinal lymph nodes (G). PET-CT image revealed abnormal accumulation of FDG in the tumor in the right lower lobe (H). Bronchoscopy revealed an endobronchial tumor covered with a whitish surface narrowing of the truncus intermedius (I). Pathological examination of the specimen obtained from transbronchial lung biopsy. Hematoxylin and eosin staining showing poorly differentiated non-small cell carcinoma. [(J) x 100, (K) x 400]. Immunohistochemistry revealed that the tumor cell was positive for p63 expression. The tumor was immunohistochemically suspected to be squamous cell carcinoma. [(L) x 100, (M) x 200].
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In computed tomography (CT) of his chest, proximal bronchiectasis and mucoid impaction were suspected (Fig. 1A-C). Chest CT was performed upon referral and the tumor, which was suspected mucoid impaction was remarkably enlarged from 59 cm x 28 cm-79 cm x 37 cm and emphysematous changes were detected (Fig. 1D-F). Positron emission tomography (PET)/CT scan with 18F-labeled fluorodeoxyglucose (FDG) revealed abnormal accumulation of FDG in the right lower tumor and hilar/mediastinal lymph nodes (Fig. 1G and H). Bronchoscopy examination revealed a pedunculated endobronchial tumor covered with a white surface obstructing the distal portion of the right bronchus intermedius (Fig. 1I). Pathologic examination of the tumor biopsy revealed poorly differentiated non-small cell carcinoma, suggesting squamous cell carcinoma (Fig. 1J, K, L, M).