PMC5403765_01
A-D, Chest computed tomography shows well-demarcated nodules at several segments in bilateral lung fields. E and F, A positron emission tomography revealed a higher standardized uptake value of pulmonary nodule at segment 3 in the left upper lobe.
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A chest X-ray showed several nodular lesions in bilateral lung fields, and computed tomography revealed multiple nodules at several segments in bilateral lung fields (Fig. 1A-D). A positron emission tomography revealed higher standardized uptake value, ranging 2.6 to 4.2 of maximum value, of pulmonary nodules, suggesting a possibility of malignancy in pulmonary involvement (Fig. 1D and E).
A and B, Specimen form video-associated thoracic surgery (VATS) shows islands of basaloid cells in cribriform patterns in a loose fibromucinous stroma. (Hematoxylin and eosin (HE) stain, x20 for A, and x40 for B). C, Well-defined basophilic tumor nests infiltrating into the dermis and subcutaneous tissue in specimen from resection of the patient's scalp nodule. (HE stain, x10). D, Pathological findings of patient's scalp nodule match with those of specimens from VATS. (HE stain, x40). E and F, Specimen form VATS shows focal nuclear expression of thyroid transcription factor 1 (TTF-1), (x40 for E and x100 for F).
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Pathological examination of the specimens from VATS revealed islands of basaloid cells in cribriform patterns in a loose fibromucinous stroma (Fig. 2A and B). The pathological findings of specimens from VATS matched with those of the patient's scalp nodule (Fig. 2D). On immunohistochemical staining of thyroid transcription factor 1 (TTF-1), all specimens demonstrated positive immunoreactivity in the present case (Fig. 2E and F).