PMC4077035_01
Enhanced chest CT scan before operation. A: In the mediastinal window, the CT scan revealed the tumor encroaching on the superior vena cava (right panel), surrounding the right upper lobe bronchus (middle panel), and invading the right pulmonary artery (left panel). B: In the lung window. C: In the mediastinal window, coronal.
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F1
Enhanced chest computed tomography (CT) with three-dimensional reconstruction of the ribs showed an enormous soft tissue mass in the left chest wall (Figure 1), which extended into the left lung and mediastinum, exerted pressure on the heart, skewing it to the right, and had eroded the middle portion of the fifth rib.
Histopathological images. (A) Gross features of the 20 cm mass with the invaded fifth rib and the left upper pulmonary lobe; (B) Hematoxylin and eosin (H&E) staining of a giant cell malignant fibrous histiocytoma cell tumor. (C) Immunohistochemical staining of primary tumor with antibodies to CD68 (+), Vimentin (+), CK (-), S-100 (-) and SMA (-).
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F2
The neoplasm, which was removed by surgical resection, weighed 2.080 kg and was 20 cm x 18 cm x 9 cm in size, as shown in Figure 2A. The pathology report described a giant cell malignant fibrous histiocytoma cell tumor (Figure 2B), with the immunohistochemistry of CD68 (+), Vimentin (+), SMA, CK and S-100 (-) (Figure 2C), invading the left upper lung lobe and the middle of the fourth, fifth, sixth ribs, with no metastases to the mediastinal lymph nodes.
CT scans after operation. The chest CT scan was performed in 7 days after the operation. A: In the mediastinal window; B: In the lung window.
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F3
She was discharged 12 days after surgery and showed no signs of local recurrence or distal disease at an 8-month follow-up visit (Figure 3).