PMC5577082_01
(a) A chest radiograph showed a tumor shadow in the right middle lung field. (b) (c) Chest computed tomography showed a right chest wall tumor.
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A chest radiograph showed a tumor shadow in the right middle lung field (Fig. 1a). Chest computed tomography (CT) showed a right chest wall tumor 27x47 mm in size with bone invasion at the eighth rib, but there were no other abnormal findings in the lung field or mediastinum (Fig. 1b and c).
(a) FDG accumulation was observed in the right chest wall. (b) No FDG accumulation was observed in the right dorsal thyroid.
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Positron emission tomography (PET) with fluorine-18 2-deoxy-2-fluoro-D-glucose (FDG) integrated with CT of the whole body showed a right chest wall tumor (maximum standardized uptake value [SUVmax] of 2.3) (Fig. 2a), and CT showed high calcification of the right dorsal thyroid, but no FDG accumulation was observed in the region (Fig. 2b).
Pathological findings of specimens obtained through a CT-guided needle biopsy: (a) Hematoxylin and Eosin staining, x20, (b) TTF-1 staining, x20, (c) CD56 staining, x20, (d) chromogranin A staining, x20.
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TTF-1 and CD56 and slightly positive staining for chromogranin A. These results suggested small cell carcinoma of primary lung cancer (Fig. 3).
Pathological findings of specimens obtained through tumorectomy by VATS: (a) Hematoxylin and Eosin staining, x20, (b) thyroglobulin staining, x20, (c) TTF-1 staining, x20, (d) CD56 staining, x20.
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The tumor had positive staining for thyroglobulin, thyroid transcription factor (TTF)-1 and CD56 and showed histology of follicular thyroid carcinoma (Fig. 4).
Pathological findings of specimens from the thyroid gland: (a) Hematoxylin and Eosin (H&E) staining, x20, (b) H&E staining of the vascular invasion findings.
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The specimens obtained from the right lobe were composed of round tumor cells with a follicle structure (Fig. 5a), and calcification of the capsule was observed. Capsule invasion was not observed, but vascular invasion was revealed by the pathological findings (Fig. 5b).