PMC8512258_01
Chest X-Ray showed a pulmonary nodule (arrow) in the right lower lobe that
measured 29 x 21 mm without any other lesions.
10.1177_2632010X211051741-fig1.jpg
PMC8512258_01_10.1177_2632010X211051741-fig1.jpg
fig1-2632010X211051741
A chest X-Ray showed a pulmonary nodule in the right lower lobe that measured 29 x 21 mm (Figure 1).
Computed tomography (CT) scan of the chest with a pulmonary nodule
(25.53 x 20.44 mm) located in the superior segment of the right inferior
lobe adjacent to the pleura.
10.1177_2632010X211051741-fig2.jpg
PMC8512258_01_10.1177_2632010X211051741-fig2.jpg
fig2-2632010X211051741
Subsequent computed tomography (CT) scan of the chest confirmed the pulmonary nodule (25.5 x 20.4 mm) located in the superior segment of the right inferior lobe (Figure 2).
Lower right lobe of the lung. Black arrow showing the tumor.
10.1177_2632010X211051741-fig3.jpg
PMC8512258_01_10.1177_2632010X211051741-fig3.jpg
fig3-2632010X211051741
The patient was cleared for surgery and a right lower lobectomy via thoracotomy was performed (Figure 3).
Histologic findings of lung tumor: (A) H&E stained sections at low power
(5x) show organoid nests of large neoplastic cells, (B and C) geographic
necrosis marked with an * (10x), (D) at high power (40x) neoplasic cells
contain abundant eosinophilic cytoplasm, granular or salt and pepper
chromatin pattern with a mitotic account of 36 mitoses per 2 mm2 (arrows),
and (E-H) immunohistochemistry (40x) shows positive cytoplasmatic staining
for synaptophysin and CK7, weak and diffuse chromogranin staining, and Ki67
was highly expressed (70%).
10.1177_2632010X211051741-fig4.jpg
PMC8512258_01_10.1177_2632010X211051741-fig4.jpg
fig4-2632010X211051741
Histologically, the tumor showed nests and sheets of monomorphic neoplastic cells, arranged in trabecular and organoid pattern in some fields (Figure 4A) with geographic necrosis and scant well-formed rosettes (Figure 4B and C). High mitotic index ratio was also observed with 36 mitoses per 10 high power field (2 mm2) (Figure 4D). Tumoral cells showed weak and diffuse chromogranin positivity and high level Ki67 staining (70%) (Figure 4E-G).