PMC9253643_01
Fluorodeoxyglucose positron emission tomography-computed tomography -PET/CT of lung lesions. Fluorodeoxyglucose shows accumulation in the left lung tumor, mediastinal lymphadenopathy, and the right 9th and 10th ribs.
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PET-CT showed sclerotic bone lesions with FDG accumulation in the right 9th and 10th ribs in addition to lung tumor and mediastinal hilar lymph nodes (Fig. 1).
Computed tomography-guided biopsy of the right 9th rib tumor. After local anesthesia using 1% xylocaine on the skin surface, muscle layer, and periosteum, a 3-mm skin cut was made and the subcutaneous skin was bluntly dissected. A computed tomography-guided needle biopsy was then performed in a trajectory tangential to the thoracic cavity.
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Histological examination of the lung tumor. Atypical cells proliferating with a solid or nests pattern are seen.Nuclear maldistribution and mucus-like material are observed. Immunohistochemical analysis shows that the tumor cells are positive for thyroid transcription factor-1 (TTF-1) and napsin A. [(A): hematoxylin and eosin (H&E) staining, bar: 200 mum], [(B): H&E staining, bar: 50 mum], [(C): TTF-1 staining, bar: 100 mum], [(D): napsin A staining, bar: 200 mum].
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Histological examination of the bone puncture biopsy.. This section shows the tissue of lamellar bone with focal remodeling, fibrosis, and pre-existing hematopoietic cells, with no apparent carcinomatous components (H&E staining, bar: 100 mum).
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No malignant cells were found in the tissue samples (Fig. 4).