PMC8600152_01
Chest radiography on admission. A nodular shadow was noted in the left upper lung field.
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A nodular shadow was noted in the left upper lung field on chest radiography on admission (Fig. 1).
Chest CT. a) Initial chest CT. A 6 mm nodule was present in the left lower lobe.. b) Chest CT 2 years later. c) Chest CT 4 years later. d) Chest CT before surgery. The nodule in the left lower lobe increased in size to 8 mm.
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On chest CT, an 8-mm nodule was present in the S6 area of the left lower lobe; this nodule was 6 mm on the initial CT during the medical checkup, and had increased in size by 2 mm over 6 years (Fig. 2).
Specimen excised by partial resection of the left lower lobe. The image shows the specimen before formalin fixation after a rapid pathological examination. The tumor was an 8-mm grayish-white nodule.
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On examination of the excised specimen, the tumor was an 8-mm grayish-white nodule with a clear boundary from the surrounding pulmonary tissue (Fig. 3).
Histological findings. a) Hematoxylin and eosin (HE)-stained specimen at 1.25 x magnification. The lesion was a nodular tumor with a clear boundary and without capsule formation.. b) HE-stained specimen at 10 x magnification. Tumor cells forming a solid mass were present around the vascular lumen, exhibiting varying degrees of dilatation.. c) HE-stained specimen at 40 x magnification. Tumor cells contained a round-to-oval nucleus and eosinophilic cytoplasm.. d) Immunohistological staining. Tumor cells were positive for alpha-SMA.. e) Immunohistological staining. Tumor cells were negative for CD34.
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Histologically, the lesion was composed of tumor cells containing a round-to-oval nucleus and eosinophilic cytoplasm exhibiting solid growth around dilated blood vessels of varying sizes (Fig. 4a, b, c). On immunostaining, the tumor cells were positive for alpha-smooth muscle actin (SMA) and negative for CD34 and pancytokeratin (Fig. 4d and e).