PMC9355509_01
Right frontal parafalcine tumor evident on T2 sagittal (A) and FLAIR axial images (B), associated with typical high choline and lipid peaks on single-voxel MR spectroscopy (C) and lack of expected enhancement on post contrast T1 sagittal image (D).
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Markedly increased choline (Cho) and lipid peak were noted on MRS ( Figures 1A-D ). Brisk mitotic activity was noted ( Figure 1A ). TTF-1 ( Figure 1B ) associated with high proliferative Ki-67 index ( Figure 2C ). These features were compatible with non-microcellular neuroendocrine lung cancer metastatic disease.
(A) On hematoxylin and eosin staining tumor cells have scant to moderate amount of eosinophillic cytoplasm, and irregular nuclei with "salt and pepper" chromatin. Brisk mitotic activity can be seen. (B) On immunohistochemical staining tumor cells nuclei strongly and diffusely express TTF-1. (C) The proliferative Ki-67 index is high (magnification, x400).
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TTF-1 ( Figure 1B ) associated with high proliferative Ki-67 index ( Figure 2C ). These features were compatible with non-microcellular neuroendocrine lung cancer metastatic disease.
An evident lesion in the upper lobe of the right lung on CT scan (A) with an avid FDG uptake (B) of the compatible with cancer on PET scan.
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PET/CT revealed a stellate lesion, with spicules radiating out from the central portion of the mass, within the right upper lung lobe, compatible with primary lung cancer, measuring 17 mm x 2 8mm ( Figure 3 ).