PMC10024129_01
Suspected primary tumor in the lower lobe of the left lung.
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fig1
After drainage of 1500 mL pleural fluid, a Computed Tomography (CT) showed a 22 mm subpleural left lower lobe tumor, ipsilateral pleural effusion (see Fig. 1), enlarged bilateral hilar and mediastinal lymph nodes, and a 36 x 24 mm hypodense lesion in cauda pancreatis with high FDG-uptake (see Fig. 2).
EUS-B guided biopsy of the pancreas.
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The lesion measured approximately 25 mm with an indistinct margin and heterogeneous echogenicity, had no blood vessels in or close to the lesion by Doppler, and was sampled with 3 passes of a 22-gauge needle (see Fig. 3).
Fine needle aspiration from the pancreas (May Grunwald-Giemsa (MGG) Stain). The red arrow indicating a cohesive cluster of malignant cells with high nuclear-cytoplasmic ratio. The green arrow is pointing benign pancreatic acinar cells. (A) Overview photomicrograph 2.5X. (B) Closer view of the above field, bottom left 20X. (C) Closer view of the above field, top right 20X. (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
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Cytological examination showed benign pancreas cells mixed with tumor cells, representing a mucinous adenocarcinoma with the same immunohistological profile as in the pleural fluid (see Fig. 4).