PMC9247284_01
Coronal scans of the adrenals (1), inguinal region (2), pelvic area (3),
portocaval (4), axillary (5), hilar (6), and peri-psoas muscle areas (7).
Sagittal scan of the cervical area (8).
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Splenic hypodensities and adrenal nodules were also discovered (Figure 1).
I(a): CD56 x100; Positive membranous staining. I(b): CK7 x400; Positive
cytoplasmic staining of tumor cells with characteristic perinuclear dots.
I(c): TTF1 x100; Positive nuclear staining. I(d): Synaptophysin x100;
Positive cytoplasmic staining. II(a): HE x100; The tumor cells are arranged
in nests of variable size and shape, some of which exhibiting peripheral
nuclear palisading, set within a desmoplastic stroma. II(b): HE x400;
Mitotic figures are also easily detected. II(c): HE x400; Tumor cells have
high nuclear to cytoplasmic ratio and exhibit an oval to round nucleus with
finely granular chromatin. Occasional necrotic areas are present (left upper
area). II(c): HE x40; Sheets of metastatic small cell carcinoma cells (left
lower half) in a lymph node (residual lymphocytes at the periphery).
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A diagnosis of PDNEC was made (Figure 2 and figure 3).
Ki-67 immunohistochemical stain revealing expression by approximately 80% of
the neoplastic cells. Original magnification 200x.
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A diagnosis of PDNEC was made (Figure 2 and figure 3).
Initial (left) FDG-PET showing increased uptake in several organs
versus mild progress seen in a comparable image
6 months later (right).
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A satellite lesion in the right lower lung lobe was also noted with an SUV = 6.9 (Figure 4).