PMC4345650_01
(a) Coronal, (b) sagittal, and (c), axial images of chest computed tomography demonstrating a mass (arrow) invading the right pulmonary artery (PA). (d) Image obtained during endobronchial ultrasound-guided transbronchial needle aspiration showing the sampling needle inside the intra-arterial mass (arrow) within the lumen of the pulmonary artery
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F1
A PET-CT scan showed a hypermetabolic mass involving the right perihilar space [Figure 1].
The fixed smears demonstrate loosely cohesive clusters of spindled cells with irregular elongated nuclei (Papanicolaou)
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F2
The smears [Figures 2 and 3] and cell block [Figure 4] primarily showed loosely cohesive clusters of pleomorphic spindled and epithelioid cells.
The air-dried smears show pleomorphic cells; many have large, irregular nuclei and finely vacuolated cytoplasm (Diff-Quik)
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F3
The smears [Figures 2 and 3] and cell block [Figure 4] primarily showed loosely cohesive clusters of pleomorphic spindled and epithelioid cells.
The cell block preparation contains pleomorphic cells with spindled and epithelioid features (H and E)
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F4
The smears [Figures 2 and 3] and cell block [Figure 4] primarily showed loosely cohesive clusters of pleomorphic spindled and epithelioid cells.
The gross resection shows the lumen of the pulmonary artery completely occulted by tumor
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F5
The pulmonary artery resection showed a 5.9 cm x 5.7 cm x 4.1 cm mass involving the right main pulmonary artery and the right upper lobe of the lung [Figure 5].
(a) The resected tumor demonstrates spindled cells with a storiform pattern (H and E). (b). Higher magnification shows pleomorphic cells with convoluted to spindled nuclei, often containing nucleoli (H and E)
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F6
Histologically, some areas showed atypical spindled cells arranged in a storiform pattern [Figure 6] while other areas contained both pleomorphic spindled and epithelioid cells.