PMC8450240_01
Chest CT confirmed a huge mass (a) in the right chest and pleural effusion (b).
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Subsequently, we performed thoracic computed tomography (CT) scan for the patient, which showed a huge mass in the right chest with pleural effusion; there were no signs of adjacent bone destruction and mass calcification (Fig. 1).
Thoracoscopy and biopsy of the patient: a A large amount of bloody effusion was found; b A solid mass with nodular appearance and multiple metastatic solid nodules were distributed on the parietal pleura; c Multiple small nodules at the visceral pleura were also detected; d Thoracoscopic biopsy of multiple lesions were conducted.
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Then, the patient underwent thoracoscopic examination, a large amount of bloody effusion was found, a solid mass with nodular appearance was located in the parietal pleura, and multiple metastatic solid nodules were distributed at the lateral wall of the parietal pleura with visceral pleura involvement (Fig. 2a-c). Thoracoscopic biopsy of multiple lesions was conducted (Fig. 2d).
Chest contrast-enhanced CT confirmed a huge heterogeneous mass (a) in the right chest and pleural effusion (b).
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After operation, the patient received chest chest contrast-enhanced CT to describe the characteristics of pulmonary lesions (Fig. 3).
Histopathological characteristics of the patient: pleomorphic tumor cells with scanty cytoplasm and hyperchromatic nuclei (hematoxylin and eosin, magnification x 40).
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Histopathological examination confirmed a small round cell malignant tumor of pleura (Fig. 4).
Immunohistochemical staining: the neoplasm was stained with antibody to CD99.
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Immunohistochemical staining showed diffuse membranous CD99 positive cells (Fig. 5), which is of diagnostic significance for Ewing's sarcoma and primitive neuroectodermal tumor, followed by a FISH image of specimens confirmed the rearrangement of the 22q12 (EWSR1 gene), a potent and reliable auxiliary technology for the EES diagnosis.