PMC3627442_01
(A) An X-ray image of the thorax. The X-ray image revealed that the right clavicle was absent, the anterior extremities of the right ribs were destructed and pleural effusion was observed on the right side of the thorax. (B) Histological changes of the right cervical ribs. Three pieces of tissue were removed from the right cervical ribs. One was a sample of non-uniform tissue with a size of 0.8x0.4x0.2 cm, while the others were two pieces of grain-like gray tissue. Proliferation of fat and fibrous connective and vascular tissue were observed under an optical microscope. Parts of vessels distended and shunted together to form a construction similar to a sinus. Hyperplastic capillaries aggregated together with monolayer flat endothelium cells coating the wall of the lumen. Proliferative collagen, a few elastic fibers and smooth muscles were observed with Masson's stain.
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Radiographs revealed the absence of the right clavicle, destruction of the anterior extremity of the right ribs and pleural effusion of the right side (Fig. 1A). The biopsy of the right cervical rib revealed considerable vascular fibrous tissue with certain vessels distending and shunting together to form sinus construction (Fig. 1B), in which there was no endothelial cell proliferation.