PMC7184791_01
Chest computed tomographic images showing a pulmonary mass in the left upper lobe with pleural effusion at the patient's first visit (a). This tumor grew rapidly to occupy the entire left upper lobe 1 month after the patient's first visit (b). Postoperative 18F-fluorodeoxyglucose positron emission tomographic images showing abnormal and diffuse accumulation of 18F-fluorodeoxyglucose in the left pleural cavity (c), which disappeared after five cycles of chemotherapy (d).
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F1
Chest computed tomography at her first visit revealed a pulmonary mass in the left upper lobe with pleural effusion (Fig. 1a). Cytology of the effusion showed no malignancy; however, only 1 month after her visit, the tumor had increased rapidly in size (Fig. 1b) and her respiratory symptoms had worsened. Postoperative 18F-fluorodeoxyglucose positron emission tomography demonstrated abnormal and diffuse accumulation of 18F-fluorodeoxyglucose in the left pleural cavity (Fig. 1c). The patient has been well without recurrence for 24 months after multidisciplinary treatment with surgery followed by systemic combination chemotherapy (Fig. 1d).
Histopathological findings showing an admixture of spindle-shaped and circular cells, arranged in a storiform pattern (hematoxylin and eosin, x100) (a). Immunohistochemical staining revealed cells positive for vimentin (x100) (b).
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F2
The resected specimen measured 15 cm (maximum size), and postoperative pathology of the specimen showed a diffuse proliferation of admixed spindle-shaped and circular, highly atypical cells, arranged in a characteristic storiform growth pattern (Fig. 2a). Immunohistochemical staining revealed that tumor cells were positive for vimentin (Fig. 2b) and negative for epithelial markers.