PMC9468772_01
The imaging characteristics of PPP on pulmonary CT scan. Chest CT showed a solid lesion in the left lower lobe at lung window (A) and at mediastinal window (B).
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A chest computed tomography (CT) scan demonstrated a well-circumscribed mass measuring 23.14 x 21.33 x 20.28 mm located in left lower lobe ( Figure 1 ).
The histopathological characteristics of the tumor in the lung demonstrated by H&E and immunohistochemical staining. (A) Hematoxylin and eosin staining. The higher power view shows uniform small round blue cells with scant cytoplasm. (B-I) Immunohistochemical staining (400xmagnification) was positive for CD38, CD138, Kappa, and LCA(CD45), CD20, but negative for CD56, CK, INSM1, respectively. (J-L) Specific stain of pathology of PAS, GMS, and acid fast stain, respectively.
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The histological examination of the specimen revealed multiple lymphocyte and plasma cells were accumulated ( Figure 2A ). INSM1 (-), CD 56(-) ( Figures 2B-I ). In addition, specific stain of pathology including PAS, GMS were negative ( Figures 2J-L ). Pathological biopsy indicated extramedullary plasmacytoma.
Serum and urine electrophoresis. No obvious abnormalities are detected in (A) Serum electrophoreis and (B) urine electrophoresis.
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The patient was further evaluated by other diagnostic tests, including urine Bence-Jones protein, serum electrophoresis ( Figure 3A ), urine electrophoresis ( Figure 3B ), and bone marrow biopsy.
The Positron emission tomography-CT imaging characteristics shows a soft tissue density with hypermetabolism in the left lower lobe, but no abnormal metabolism in other organs and tissues, and no osteolytic lesions.
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There were no signs of abnormal metabolism in other organs and tissues, and no osteolytic lesions ( Figure 4 ).