PMC5004033_01
(a) CT thorax, coronal slice demonstrating a radiopaque hilar mass; (b) the hypervascular mass, as seen under bronchoscopic exam, occluding the bronchus; (c) the right middle lobe resection specimen. The mass encases the bronchial resection margin. The fleshy, endobronchial portion (*) was sampled at the time of frozen section.
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Chest CT imaging revealed a calcified 4.2 cm hilar mass with associated right middle lobe collapse (Figure 1(a)). Bronchoscopy confirmed the presence of a highly vascular and obstructive endobronchial mass (Figure 1(b)). Intraoperative gross specimen assessment revealed a hard, well-circumscribed, ossified 5.0 cm mass (Figure 1(c)) encasing the bronchial resection margin.
((a) and (b)) Cytology scrape smears including Diff Quik, 20x (c) and H&E, 20x (inset 40x); (c) H&E section of calcified mass demonstrating mature lamellar bone and nests of tumor cells; (d) trabecular structures and vague rosettes were noted (40x); the tumor cells were diffusely positive for chromogranin positivity, synaptophysin, and cytokeratin AE1/3.
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The smears contained a uniform population of tumour cells disposed singly and in loosely cohesive groups and rosettes (Figure 2(a)). The H&E scrape smear preparation confirmed the presence of a stippled "salt and pepper" chromatin pattern, characteristic of low grade neuroendocrine tumours (Figure 2(b)). The cells were occasionally arranged in trabecular structures and vague rosettes (Figures 2(c) and 2(d)).