PMC6041373_01
CT shows (A) a solid nodule in the right lung (white arrowhead) and (B) slight enlargement of the interlobar lymph node (white arrowhead).
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Computed tomography (CT) showed an irregularly shaped, 27-mm-diameter, solid nodule with pleural indentation in the superior segment (segment 6) of the right lower lobe and a slightly enlarged interlobar lymph node (#11i) (Fig. 1).
FDG-PET shows high FDG uptake in the right lower lobe (SUVmax = 6.5) and interlobar lymph node #11i, between the right middle and lower lobe bronchi (SUVmax = 2.7) (white arrowhead).
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Levels of serum tumor markers, including carcinoembryonic antigen, neuron-specific enolase, cytokeratin 19 fragment, and pro-gastrin-releasing peptide, were within the normal range. 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) showed high FDG uptake in the primary lesion in the right lower lobe [maximum standardized uptake value (SUVmax) = 6.5] and in the #11i lymph node (SUVmax = 2.7), suggesting metastasis (Fig. 2).
Histologically, the tumor cells have a biphasic appearance with epithelioid and spindle cell sarcomatous components (hematoxylin and eosin staining; magnification, x 400). Pulmonary pleomorphic carcinoma with adenocarcinoma components was diagnosed.
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Consequently, a diagnosis of pulmonary pleomorphic carcinoma was made (Fig. 3).
Histologically, the #11i lymph node reveals a schwannoma composed of spindle-shaped cells with nuclear palisading arranged in interlacing bundles (hematoxylin and eosin staining; original magnification, x 100).
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These findings were compatible with schwannoma (Fig. 4).