PMC6159296_01
Initial chest AP radiograph showing mediastinal widening and nodular consolidation in the left lower lobe and pleural effusion. The trachea is deviated to the right side. L-AP, left anteroposterior.
bjrcr.20160051.g001.jpg
PMC6159296_01_bjrcr.20160051.g001.jpg
f1
(a) A CT scan showing a huge lobulated mass involving the oesophagus (E), mediastinum and lower neck (not revealed) with enlarged lymph nodes. The scan reveals a large amount of pericardial effusion and extraluminal air bubbles at the mediastinum (arrows). A relatively preserved trachea (T) is noted without definite extrinsic compression. (b) A large amount of pericardial effusion and extraluminal air bubbles along the pericardium are seen. Consolidation in the left lower lobe with left pleural effusion is noted.
bjrcr.20160051.g002.jpg
PMC6159296_01_bjrcr.20160051.g002.jpg
f2
Endoscopic study revealing a huge oesophageal ulcer encircling the oesophageal lumen at 20-30 cm from the incision.
bjrcr.20160051.g003.jpg
PMC6159296_01_bjrcr.20160051.g003.jpg
f3
Lower magnification view of an oesophageal biopsy specimen shows infiltrating tumour tissue arranged in solid nests. Tumour necrosis is also noted (haematoxylin and eosin, x100).
bjrcr.20160051.g004.jpg
PMC6159296_01_bjrcr.20160051.g004.jpg
f4
Endoscopic biopsy was performed of the oesophageal lesion and histological analysis of the biopsies suggested small cell carcinoma (SCC; Figures 4-7).
Higher magnification view of an oesophageal specimen shows small hyperchromatic cells with finely granular chromatin, inconspicuous nucleoli, scanty cytoplasm and nuclear moulding (haematoxylin and eosin, x400).
bjrcr.20160051.g005.jpg
PMC6159296_01_bjrcr.20160051.g005.jpg
f5
Endoscopic biopsy was performed of the oesophageal lesion and histological analysis of the biopsies suggested small cell carcinoma (SCC; Figures 4-7).
Tumour cells stained positive for CD56 (x400).
bjrcr.20160051.g006.jpg
PMC6159296_01_bjrcr.20160051.g006.jpg
f6
Endoscopic biopsy was performed of the oesophageal lesion and histological analysis of the biopsies suggested small cell carcinoma (SCC; Figures 4-7).
Tumour cells stained positive for synaptophysin (x400).
bjrcr.20160051.g007.jpg
PMC6159296_01_bjrcr.20160051.g007.jpg
f7
Endoscopic biopsy was performed of the oesophageal lesion and histological analysis of the biopsies suggested small cell carcinoma (SCC; Figures 4-7).
Chest axial (a) and coronal reconstructed (b) CT with contrast enhancement was performed. Residual pericardial effusion and thin diffuse pericardial enhancement were seen in addition to a huge mass encircling the oesophagus, mediastinum and lower neck, and metastatic lymphadenopathy.
bjrcr.20160051.g008.jpg
PMC6159296_01_bjrcr.20160051.g008.jpg
f8
Positron emission tomography/CT scan was performed on the same day with enhanced CT scan, showing very strong uptake at the mediastinal mass and lymph nodes.
bjrcr.20160051.g009.jpg
PMC6159296_01_bjrcr.20160051.g009.jpg
f9
Chest CT scan with contrast enhancement was performed after 5 months from the initial CT scanning (after seven cycles of chemotherapy). The image shows markedly decreased size of the mediastinal mass, leading to improvement in dyspnoea, and left arm oedema. Residual pericardiac effusion and thin diffuse pericardial enhancement were seen in addition to a huge mass encircling the oesophagus, mediastinum and lower neck, and metastatic lymphadenopathy.
bjrcr.20160051.g010.jpg
PMC6159296_01_bjrcr.20160051.g010.jpg
f10