PMC6115605_01
Pre-operative chest computed tomography images showing solid tumors in the left upper lobe (A), right lower lobe, and left lingular segment (B).
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They were homogeneous and of regular shape; no enhancement was noted (Fig. 1).
Photomicrograph at low magnification revealing a well-demarcated nodule in the lung parenchyma (A). The nodule consists of a solid sheet of cells with lightly eosinophilic or prominent vacuolated cytoplasm (physaliphorous cells) (B). The tumor cells have hyperchromatic eccentric nuclei and are surrounded by a myxoid extracellular matrix that is Alcian blue positive (C, D). The nuclei of the tumor cells are positive for brachyury (E). A-C, H&E stain; D, Alcian blue-Periodic acid Schiff; E, immunostaining for brachyury.
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Alcian blue-positive myxoid extracellular matrix was observed in some areas (Fig. 2A-D). Immunohistochemically, the tumor cells were positive for cytokeratin AE1/AE3, S-100 protein, epithelial membrane antigen, cytokeratin 19 and brachyury (Fig. 2E).