PMC4774465_01
Chest radiographs (A) prior to and (B) following clarithromycin treatment. (A) At the time of the first relevant examination (FRE), infiltration shadows near the aorta and left lower field, and a small nodular shadow in upper right lung field were observed (arrows). (B) Nine months following initiation of clarithromycin treatment (~1 year following FRE), the infiltrative shadows have improved and have almost disappeared.
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Chest radiography and computed tomography (CT) revealed infiltrative shadows primarily in the left pulmonary hilum, and small nodular shadows in both the right and left lung fields (Figs. 1 and 2). The chest shadows had almost completely disappeared on the images obtained eight months following clarithromycin therapy (Figs. 1 and 2).
Chest computed tomography (CT) imaging during the clinical course. At the time of the first relevant examination (FRE), infiltrative shadows were observed near the aorta and the left-lung hilus (A, upper and lower panels). The shadows increased and a portion developed into nodules (B, upper and lower panels) two months following FRE. Five months following FRE (two months following initiation of clarithromycin treatment), the shadows disappeared gradually (C, upper and lower panels). One year following FRE (nine months following treatment), the infiltrative shadows had almost disappeared and had improved (D, upper and lower panels). Upper panels, CT images at the level of the aorta. Lower panels, CT images near the hilus of the left lung.
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Chest radiography and computed tomography (CT) revealed infiltrative shadows primarily in the left pulmonary hilum, and small nodular shadows in both the right and left lung fields (Figs. 1 and 2). The chest shadows had almost completely disappeared on the images obtained eight months following clarithromycin therapy (Figs. 1 and 2).
Micrographs of the excised inflammatory myofibroblastic tumor with histological analyses. (A) Hematoxylin and Eosin staining, representative of the center of the lesion and characterized by haphazardly-arranged spindle cells in an inflamed stroma (Scale bar, 100 microm). (B) Spindle cells with strong reactivity for alpha-smooth-muscle-actin (Scale bar, 100 microm). (C) Positivity for vimentin (Scale bar, 200 microm). (D) No staining detected for anaplastic lymphoma kinase (Scale bar, 200 microm). (E) No staining detected for IgG4 (Scale bar, 200 microm). (F) No staining detected with direct fast scarlet (Scale bar, 200 microm).
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The immunostaining revealed that the nodule was vimentin-positive, strongly alpha-SMA-positive, CD34-negative, CD68-positive, Congo-red-negative, ALK-negative and IgG4-negative (Fig. 3).