PMC3161662_01
Chest CT in 2003 (a) demonstrated a CT thick-walled cystic lesion in the superior segment of the lower lobe of the right lung. A corresponding CT image in 2004 (b) demonstrated increased thickening of the wall.
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Tokyo) with a conventional protocol without enhancement (10-mm collimation, 10-mm intervals, 120 kVp, 200 mAs, gantry rotation time; 1.0 sec.) showed moderate wall thickening (Fig. 1a). The patient underwent repeated sputum examinations, and then bronchoscopic lung biopsy and bronchial washing targeting the right B6 segment. Chest CT, acquired by the same protocol as in 2003 without enhancement, disclosed diffuse thickening of the cyst wall (Fig. 1b).
Macroscopic examination of the excised right lower lobe (a) showed the mass to have two-layered structure, with outer and inner zones. Microscopically the outer layer, (labeled "O" in (a) showed compact proliferation of atypical cells with "pearl" formation in some areas, characteristic of squamous cell carcinoma (Hematoxylin-Eosin stain, bar = 25 mum) (b). The inner layer, (labeled "I" in (a), showed septate, and branching hyphae (Hematoxylin-Eosin stain, bar = 25 mum) (c).
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Macroscopically the resected lesion was solid, but with an outer and inner component (Fig. 2a). Microscopically, the outer portion (labeled "O" in Fig. 2a) showed dense proliferation of atypical cells with focal "pearl" formation, characteristic of squamous cell carcinoma (Fig. 2b). The inner layer (labelled "I" in Fig. 2a) was composed of septate, branching hyphae (Fig. 2c).