PMC10083322_01
Timeline of the clinical course of the patient.
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The patient's clinical course is illustrated in  Figure 1 .
Cellular characterization of the disease course. (A) Neoplastic cells arranged in confluent papillary and glandular structures. (B) The tumor was arranged in infiltrative nests, with necrosis and focal extracellular and intracellular mucin production noted. (C) Tumor cells were arranged in solid nests and occasional papillary structure, with lymphovascular invasion also present. (D-F) Immunochemical staining to detect SMARCA4 corresponding to the above specimen; all these tumors cells were negative for SMARCA4 expression. (G-I) CD34 is weakly positive. (J, K) Claudin4 is negative. (L, M) SALL4 is negative. (N, O) SOX2 is negative.
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Lymph node biopsy via mediastinotomy was performed and pathology demonstrated metastatic carcinoma ( Figure 2A ). TTF-1, Claudin4, SALL4, SOX2 and SMARCA4 ( Figure 2 ). Pathology disclosed adenocarcinoma ( Figure 2C ) this time. TTF-1; weakly positive for CD117 and p40; but still negative for SMARCA4 ( Figure 2D ). The patient underwent chemotherapy with four cycles of vinorelbine and cisplatin. Pathology this time disclosed poorly differentiated carcinoma ( Figure 2E ). Immunohistochemically, the tumor cells were positive for CK7; occasionally positive for p40; but not positive for TTF-1, CK20, CD5, and SMARCA4 ( Figure 2F ).