PMC5577085_01
Imaging findings. a: A chest computed tomographic scan showing a right upper lobe mass. b: 18F-fluorodeoxyglucose positron emission tomography scan combined with computed tomographic scan showing an increased 18F-fluorodeoxyglucose uptake in the bilateral hilar and mediastinal lymph nodes. c: Magnetic resonance image showing a destructive lesion of the T11 vertebral body.
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Computed tomography (CT) of the chest demonstrated a right upper lobe mass that was located adjacent to the pleura exhibiting irregular margins, air bronchograms, and vascular convergence (Fig. 1a). Although mediastinal lymphadenopathy was not detected on CT, 18F-fluorodeoxyglucose (FDG) positron emission tomography showed an increased FDG uptake in the bilateral hilar and mediastinal lymph nodes (LNs) (Fig. 1b) as well as in the pulmonary mass. Magnetic resonance images showed large destructive lesions of the T6 and T11 vertebral bodies (Fig. 1c).
Histopathological findings. a: A lymph node specimen showing numerous non-necrotizing granulomas composed of epithelioid cells and multinucleated giant cells with asteroid bodies (arrows) [original magnification x100, Hematoxylin and Eosin (H&E) staining]. b: A bone biopsy specimen showing monotonous plasma cell infiltration (original magnification x400, H&E staining).
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A LN specimen showed numerous non-necrotizing granulomas composed of epithelioid cells and multinucleated giant cells (Fig. 2a). Posterior fixation surgery was performed at T10 to T12, and an examination of a tumor biopsy specimen showed the monotonous and destructive infiltration of CD138 and kappa light chain-positive plasma cells (Fig. 2b).