PMC3031020_01
Computed tomography of the chest showed irregular pleural thickening and pleural effusion in the left lung.
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F1
Computed tomography (CT) of the chest showed irregular pleural thickening and pleural effusion in the left lung (Fig. 1).
Pathologic features of an incisional biopsy of the pleura. (A) The growth pattern of the tumor is infiltrative with a desmoplastic stroma (H&E, x 100). (B) The tumor cells shows oval to spindled and indented nuclei and abundant cytoplasm with indistinct border (H&E, x 400).
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F2
The cytoplasm of the tumor cells was abundant and slightly eosinophilic with an indistinct border (Fig. 2).
Immunohistochemistry showed that the tumor cells were positive for (A) S100 and (B) CD 45 (x 400).
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F3
Thermo, Fremont, CA, USA). Immunohistochemistry showed that the tumor cells were positive for S100, CD45 (Fig. 3), vimentin, and CD68, but negative for cytokeratin (epithelial cell marker), myeloperoxidase (myeloid cell marker), HMB45 (melanoma marker), CD1a (LCS marker), CD3 (T-cell marker), CD20 (B-cell marker), CD21, CD23, CD35 (FDCS marker), CD31 (vascular endothelial cell marker), CD34 (myeloid stem cell marker), CD56 (neuroendocrine cell marker), CK5, CK6, WT-1, and calretrenin (mesothelioma marker). The proliferation index (Ki 67) of the neoplastic cells was approximately 25%.
Corresponding positron emission tomography (PET)-CT image showed 18-fluoro-deoxyglucose (FDG) uptake (standardized uptake value, SUV, 10.5 and 9.8), by thickened pleura of the left hemithorax and the whole axial skeleton, which was compatible with malignant tissue.
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F4
The patient underwent a positron emission tomography (PET)-CT scan, which revealed 18-fluoro-deoxyglucose (FDG) uptake in the thickened pleura and whole axial skeleton (standardized uptake value (SUV); 10.5 and 9.8) compatible with malignant tissue (Fig. 4).