PMC9685204_01
A Positron Emission Tomography (PET) scan showing focal intense
hypermetabolic activity in the apex of the left eye with a size of 1 cm in
diameter and 7.7 Standard Uptake Value. The findings were highly suspicious
of metastatic disease.
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The scan showed a focal intense hypermetabolic activity in the apex of the left orbit (at the site of the diagnosed soft tissue lesion by MRI) with a Standardized Uptake Value (SUV) of 7.7 and a size of 1 cm in diameter, highly suggestive of malignancy (Figure 1).
A Positron Emission Tomography (PET) scan showing nodular thickening of the
right pleura with intense hypermetabolic activity and underlying
infiltrative nodular lung changes and loss of volume. The features were
highly suspicious for mesothelioma.
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The scan also disclosed a 2.5 cm nodular thickening of the right pleura with intense hypermetabolic activity and underlying infiltrative nodular lung changes and loss of volume with a prominent hypermetabolic collapsed tissue/round-like mass lesion within the superior right lower lobe (Figure 2). Two small hypermetabolic left liver lobe lesions and a small hypermetabolic nodule within the left adrenal gland were also noted and deemed likely metastatic.
Lymphohistiocytic pleuritis. (A) Dense inflammatory reaction admixed with
fibroblastic proliferation, H&E, low power view (10x). (B) Prominent
lymphohistiocytic infiltrate with fibroblastic proliferation and collagen
deposition, H&E, high power view (40x). (C) Pleural core biopsy. (D)
Lymphohistiocytic reaction infiltrating the adjacent skeletal muscles,
H&E, high power view (40x). (E) Positive expression of cytokeratin
immunohistochemical stain, pleural core biopsy. (F) Positive expression of
CD68 immunohistochemical stain. (G) Negative expression of calretinin
immunohistochemical stain. (H) Negative expression of WT-1
immunohistochemical stain.
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The inflammatory infiltrate was composed of histiocytes, lymphocytes, rare plasma cells with scattered multinucleated giant cells that percolate the adjacent skeletal muscles, and adipose tissue (Figure 3).