PMC7303991_01
Chest CT on admission. Chest CT showed an irregularly shaped nodule 24 mm in maximum diameter in the S9 region and consolidation in the S6 region of the right lung (arrowheads) (A, B: lung windows), along with osteoblastic bone lesions in Th11 and L2 (arrow) (C, D: soft-tissue windows).
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FDG-PET/CT of lung lesions. Fluorodeoxyglucose was concentrated in the primary lung lesions (arrow).. There was no significant accumulation in the area of consolidation in the right lower lobe (arrowheads).
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Th11 and L2 vertebral lesions (SUVmax = 3.13, 2.54) (Fig. 2).
FDG-PET/CT of the metastatic vertebral lesions of lung cancer. Fluorodeoxyglucose was mildly concentrated in the Th11 and L2 vertebral lesions (arrows).
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There was no significant accumulation in the area of consolidation in the right lower lobe (SUVmax = 1.64) (Fig. 3). Transbronchial lung biopsy of the nodular shadow in the S9 segment of the right lung was performed.
Histological examination of the lung. Tumor cells showed invasive growth with a partial glandular arrangement in the right S9 segment [(A): Hematoxylin and eosin (H&E) staining, bar: 200 mum], [(B): H&E staining, bar: 50 mum].
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Histological examination of the lung revealed invasive adenocarcinoma (Fig. 4).
Histological examination of the metastatic bone tumor.. Tumor cells were observed between the trabecular bones in the bone sclerosis area (arrows). Immunohistochemical analysis showed that the tumor cells were positive for TTF-1 and CK7. [(A): H&E staining, bar: 200 mum], [(B): H&E staining, bar: 50 mum], [(C): TTF-1 staining, bar: 100 mum], [(D): CD7 staining, bar: 200 mum].
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Histological examination of the bone lesions (Fig. 5) showed metastasis of tumor cells between the trabecular bones in the bone sclerosis area.
Patient's clinical course. The clinical course, laboratory data, radiological findings and treatment of the present case.
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This led to significant reduction in both her primary and bone metastasis. (Fig. 6).