PMC6551867_01
Chest enhanced computed tomography (CT) showed a solid lesion in the apical segment of right lower lobe with multiple confluent mediastinal adenopathies and right paratracheal lymphadenopathy
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Fig1
He performed a chest CT scan, showing a solid lesion in the apical segment of right lower lobe with multiple confluent mediastinal adenopathies and right paratracheal lymphadenopathy (Fig. 1).
Chest radiography and Computed Tomography (CT) showed a solid neoplastic lesion in the apical segment of the right lower lobe and significant stenosis of the tracheal lumen
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Fig2
Chest x-ray and CT scan showed deterioration of the radiological picture with stenosis of the tracheal lumen (Fig. 2).
Bronchoscopy revealed that the tumor completely obstructed the tracheal lumen
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Fig3
The patient made videobronchoscopy that showed a vegetative neoformation which obstructed the tracheal lumen about 6.5 cm far from the true vocal cords (Fig. 3).
After bronchial disobstruction, bronchoscopy revealed the recanalization of tracheal lumen
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Fig4
The patient was intubated with a rigid bronchoscope Storz n 14 and we used laser photocoagulation to devascularize the lesion that was subsequently removed with a debulking maneuver, recanalizing the trachea (Fig. 4).
a) 100 enlargements, hematoxylin and eosin. Solid-growth non-small cell epithelial neoplasia. On the right fragment of ciliated cylindrical epithelium of the respiratory tract; b) 200 enlargements, same field; c) 200 enlargements, immunohistochemical anti-hepatocyte antigen: diffuse cytoplasmic granular positivity according to the hepatic origin of the neoplasia (hepatocellular carcinoma)
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Fig5
The anatomopathological findings confirmed the previous diagnosis of hepatocarcinoma metastases (Fig. 5).