PMC5340659_01
Chest computed tomography scan with contrast showing a left upper lobe spiculated nodule (arrow), which is consistent with primary lung cancer.
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F1
At her initial presentation, computed tomography scan of the chest with contrast showed a large left upper lobe spiculated nodule with extensive lymphadenopathy that encased major blood vessels, the esophagus, and the trachea with impending tracheal obstruction due to intraluminal tumor mass (Figure 1).
EGD showing 1 of 3 nodules with overlying mucosa, which appeared inflamed and ulcerated. Biopsy showed metastatic deposits from lung primary.
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F2
A red spot that could not be washed and three nodules with overlying mucosa, which appeared inflamed and ulcerated, were found in the body of the stomach (Figure 2).
(A) Staining of the stomach nodule biopsy showing poorly differentiated malignant-appearing cells (hematoxylin & eosin, 20x). (B) Immunohistochemistry positive for TTF-1, indicating lung origin (10x).
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F3
Biopsy of the nodules revealed poorly differentiated tumor cells with a similar morphological and immunohistochemical profile to the tumor from the tracheal biopsy, therefore consistent with metastatic deposits from her poorly differentiated lung adenocarcinoma (Figure 3).