PMC6838485_01
Chest CT showing left pneumothorax and a lesion measuring 18 mm in diameter in the inferior lingular segment of the lung.
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Chest CT revealed left pneumothorax and a lesion measuring 18 mm in diameter in the inferior lingular segment of the lung (Fig. 1).
Pathological findings of the lung. A) hematoxylin-eosin staining. Magnification 400x. B) chromogranin A staining. Magnification 200x. C) synaptophysin staining. Magnification 200x.
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Nucleoli were sometimes prominent (Fig. 2a). Moreover, staining of the tumor was positive for chromogranin A (Fig. 2b) and synaptophysin (Fig. 2c), which are neuroendocrine markers.
A) Abdominal CT showing a mass measuring 27 mm in diameter in S7 of the liver. B) FDG-PET showing high accumulation of FDG with an SUVmax 3.4 in the liver tumor.
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Four years after surgery, the level of progastrin-releasing peptide (ProGRP), a specific neuroendocrine tumor marker, was elevated and dynamic contrast-enhanced CT revealed a mass measuring 27 mm in diameter in segment 7 (S7) of the liver (Fig. 3a). 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed a high accumulation of FDG with a maximum standardized uptake value (SUVmax) of 3.4 in the liver tumor (Fig. 3b), and no other high uptake value.
Intraoperative fusion ICG-fluorescence imaging.
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After the right lobe was mobilized, fusion ICG-fluorescence imaging indicated that a green pseudocolor tumor was present on the liver surface of S7 (Fig. 4).
Pathological findings of the liver (hematoxylin-eosin staining. Magnification 400x).
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The resected tumor was pathologically similar to the primary lung LCNEC (Fig. 5) and staining of the tumor was positive for chromogranin A and synaptophysin.