PMC7288224_01
Microscopy (slides prepared for cell block analysis): (a) hematoxylin and eosin (H&E) slides consists of malignant cells, single and molding in groups with increased nuclear to cytoplasmic ratios, irregular nuclear contours, and hyperchromatic (200x magnification). ((b)-(e)) Immunohistochemistry (IHC) stains of synaptophysin (b), chromogranin (c), CD56 (d), and TTF-1 (e) are positive in the malignant cells (200x magnification). P63 IHC stain is negative (not shown).
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fig1
Fine-needle aspiration of the R4 lymph nodes was positive for small-cell carcinoma (Figure 1).
((a) and (b)) Axial FLAIR MRI showing slight increased signal in bilateral temporal lobes.
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fig2
However, the neuroradiology service, upon reviewing the brain MRI, was not convinced that the findings represented limbic encephalitis (Figure 2).