PMC4310203_01
CT scan of the chest. CT of the thorax (horizontal section) showing a large mass measuring 4.6 x 12.0 x 8.1 cm, encasing the left pulmonary artery and segmental branches (arrows).The mass also abutts the left mainstem bronchus with partial encasement. Moderate-sized left pleural effusion (arrow heads).
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Fig1
Computed tomography (CT) and positron emission tomography (PET) scans showed a large left upper lobe fludeoxyglucose (FDG)-avid mass (standardized uptake value (SUV) 14.3) and enlarged left supraclavicular lymph nodes with avid FDG uptake (SUV 4.0) (Figures 1 and 2).
Whole body PET scan using 18 F-FDG. PET scan shows a left upper thorax tumor mass (arrow) and metastases to left supraclavicular lymph nodes (arrow head).
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Fig2
Computed tomography (CT) and positron emission tomography (PET) scans showed a large left upper lobe fludeoxyglucose (FDG)-avid mass (standardized uptake value (SUV) 14.3) and enlarged left supraclavicular lymph nodes with avid FDG uptake (SUV 4.0) (Figures 1 and 2).
CT scan of the abdomen. CT scan of the abdomen showing a distention of small bowel loops with several air-fluid levels.
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Fig3
CT scan revealed small bowel distention with multiple air-fluid levels (Figure 3). Considering possible mechanical bowel obstruction surgery was consulted and the patient underwent small bowel resection of the terminal ileum and cecum.
H & E stains of resected sample of the small intestine. The myenteric plexi show an increased lymphoid infiltrate (100x, arrows), with a few plexi having a rather dense lymphoplasmacytic infiltrate (400x, arrows) consistent with myenteric ganglioneuritis. Magnification as indicated.
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Fig4
However, no tumorous obstruction was found and histologic examination of the resected sample revealed intense lymphoplasmacytic infiltration consistent with myenteric ganglioneuritis as this is typically found in CIPO (Figure 4).