PMC6901962_01
Pupils were mid-position in ambient light (A) without constriction in response to bright light. (B) Thirty minutes following diluted (0.0625%) pilocarpine solution, pupillary constriction of right eye was noted.
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F1
Neurological examination revealed a right-sided tonic pupil, 5 mm in diameter (Figure 1A) with no response to light. Thirty minutes after local instillation of one drop of diluted pilocarpine (0.0625%) in each eye, the right pupil constricted, whereas the left pupil remained unchanged (Figure 1B), a finding consistent with unilateral Adie's pupil.
Thoracic radiograph and PET-CT findings of the patient. (A) Chest X-ray showed a round soft tissue mass (arrow) in the upper-mid mediastinum and infiltrating right lung field. (B) Thoracic CT showed a round soft tissue mass (arrow) located in the upper-mid mediastinum before the arteroae aorta. (C,D) PET-CT scan showed increased uptake of fluorodeoxyglucose signal in this mass axial and coronal plane images. (E) Repeated thorax CT showed the resolution of the mediastinal mass after chemotherapy.
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F2
A chest radiograph showed a round soft tissue mass located in the upper-mid mediastinum (Figure 2A). A thoracic computed tomography (CT) scan showed a round soft tissue mass (3.6 x 2.7 x 4.5 cm) located in the upper-mid mediastinum (Figure 2B). Whole-body positron emission tomography (PET)-CT demonstrated a significant increase in the fluorodeoxyglucose signal in this round mass (Figures 2C,D). Three months after the diagnosis and receiving chemotherapy for three cycles, repeated thorax CT showed the resolution of the mediastinal mass (Figure 2E).
The cytology of the mediastinal mass showed small round/oval cells with high nuclear/cytoplasmic ratio, consistent with primary SCC. (A) 40x, (B) 100x.
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F3
With the help of chest physicians, an endobronchial ultrasound bronchoscopy aspiration of the mass confirmed the presence of primary SCC by cytology (Figures 3A,B).