PMC7256324_01
Fine-needle aspiration cytology (FNAC) of the thyroid nodule (A) and a cervical lymphadenopathy (B): clusters of tumor cells with basophilic cytoplasm and atypical nucleated nuclei.. Pathological examination of the lymphadenopathy (Biopsy):. (C) (HEx100): Lymph node tissue is massively infiltrated by carcinomatous proliferation. (D) (HEx400): Ganglion tumor cells are polygonal with eosinophilic cytoplasm and moderately atypical nuclei, mitosis are numerous. (E): Immunohistochemistry (IHC) testing for CK7: Tumor cells are positive for CK7.
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The two FNAC findings matched and showed clusters of tumor cells with basophilic cytoplasm and atypical nucleated nuclei in favor of a poorly differentiated adenocarcinoma (Fig. 1). Immunohistochemistry (IHC) showed positive tumor cells with cytokeratin (CK) 7 but negative with TTF1 (Fig. 1).
Thoraco-abdomino-pelvic Computed Tomography (CT) scan in axial section and mediastinal window showing:. A + B: Hypodense left thyroid nodule.. C + D: Right mediastino-hilar tumor mass of 11 cm long axis with invasion of the carina, pericardium, esophagus with thrombosis of the right inferior pulmonary vein, of the right sub claviar vein as well as significant mass effect on the right internal jugular vein.. Multiple adenomegalies of secondary appearance mediastinal hilar bilateral and left axillary.. E: Bilateral renal, left adrenal and splenic secondary lesions.
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Computed Tomography (CT) scan of the thorax showed a 11.4 x 10 x 9.7 cm right hilar mass presenting a mediastinal extension involving carina, pericardium, and esophagus with multiple hilar and mediastinal lymph nodes (Fig. 2. C + D). Cervical CT sections confirmed the ultrasound findings (Fig. 2. The abdominal CT scan showed multiple renal, adrenal, and splenic metastasis (Fig. 2.