PMC6498978_01
The whole body bone imaging examination. (A) Showed abnormal bone metabolism, consistent with the signs of multiple bone metastases: The right side of mandible, chest 11, left side of lumbar 2 vertebra, left side of lumbar 4 vertebra pedicle, sacrum and right side of sacroiliac joint showed increased patchy radioactive uptake, and the right side of pyramidal 8 and 10 showed slightly increased reflective uptake. (B) Showed abnormal bone metabolism was significantly alleviated after 6 months of hormone therapy for prostate cancer.
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The whole body bone imaging examination showed abnormal bone metabolism, consistent with the signs of multiple bone metastases (Figure 1). The whole body bone imaging examination showed abnormal bone metabolism was significantly alleviated (Figure 1).
Hematoxylin-eosin-stained (10*20) biopsy specimens obtained by broncho berscopy. The tumor cells are large with highly atypical nuclei, and the histology and immunohistochemical findings suggest adenocarcinoma. Immunohistochemical results: TTF-1(+), CK7(+), P63(-), P40(-), NapsinA(+).
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The histopathologic findings revealed hypodifferentiated adenocarcinoma after a biopsy specimen obtained by fiber-optic bronchofiberscopy (Figure 2).
The tumor was compared between lung window and mediastinal window on chest CT. Chest CT showed that the lung tumor size was significantly reduced in January 19, 2017 (B, D) compared with September 1, 2016 (A, C).
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CT until 3 months later. CT results showed a marked reduction in tumor size (Figure 3).
Prostrate MRI examination. Abnormal signal foci in the central region of prostate magnetic resonance imaging in September 1, 2016 (A), irregular enlargement of prostate and abnormal signal in April 17, 2017 (B), which was considered as prostate cancer.
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The results of urological magnetic resonance imaging (MRI) examination showed irregular enlargement of prostate and abnormal signal (Figure 4), which considered prostate cancer, not excluding left seminal vesicle gland involvement, while the left bladder wall occupied space (Figure 5), pelvic lymph node enlargement.
Bladder MRI examination. In September 1, 2016 (A) the bladder was poorly filled, with several prominent shadow-like sacs on the left side wall; sacs on the left side wall had grown up to be occupied space in April 17, 2017 (B).
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The results of urological magnetic resonance imaging (MRI) examination showed irregular enlargement of prostate and abnormal signal (Figure 4), which considered prostate cancer, not excluding left seminal vesicle gland involvement, while the left bladder wall occupied space (Figure 5), pelvic lymph node enlargement.
Chest CT. Partial nodules decreased in both lungs (considering the metastasis of prostate cancer in the lungs) in September 3, 2017 (B, D) compared with April 12, 2016 (A, C).
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CT also showed partial nodules decreased in both lungs (considering the metastasis of prostate cancer in the lungs) (Figure 6), new nodules appeared, and pericardial effusion did not change significantly.
Hematoxylin-eosin-stained (10x20) surgical specimens obtained by transurethral electric resection of bladder lesions. The tumor cells are large with highly atypical nuclei and the histology and immunohistochemical findings suggest invasive urothelial carcinoma. Immunohistochemical results: CK7(+), CK20(-), Ki-67(about ~30%+), P53(Scattered+), P63(+), GATA3(+), 34BE12(+), PSA(-).
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Postoperative pathology showed invasive urothelial carcinoma (Figure 7).