PMC3134035_01
An enhanced chest CT scan shows a small mass in the superior sulcus with invasion into the mediastinum (a, b). The sagittal view reveals a cavity in the mass and compression of the stenotic trachea by the mass (c).
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F1
An enhanced chest CT scan revealed a small mass in the superior sulcus invading into the mediastinum (fig. 1).
Percutaneous needle biopsy specimen shows tumor cells with enlarged nuclei and scanty cytoplasm (HE, x100). Immunohistochemically, the tumor cells are positive for CK-7 (b) and negative for CK-14 (c) and TTF-1 (d) (x400).
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F2
The patient was diagnosed with poorly differentiated lung carcinoma by percutaneous needle biopsy (fig. 2).
Upper gastrointestinal endoscopy reveals the fistula located in the upper esophagus (a). Bronchoscopy shows a tracheal cavity communicating with the esophagus (b). A follow-up upper gastrointestinal endoscopy reveals a covering of epithelial tissue over the fistula (c), and bronchoscopy shows only one slit on the trachea (d).
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F3
When his respiratory condition improved enough to permit bronchoscopy and upper gastrointestinal endoscopy, these modalities revealed a hole with ulcerative edges in the trachea and upper esophagus (fig. 3). A bronchoscopy a few days later revealed only one slit on the trachea, and upper gastrointestinal endoscopy showed a covering of normal epithelial tissue over the fistula (fig. 3).