PMC2739437_01
(a) Chest X-ray with interstitial pattern; (b) thoracic high-resolution CT with septal thickening and small left pleural effusion; (c) small nodule in RLL; (d) disappearance of pleural effusion and appearance a vertebral metastasis after 6 cycles of chemotherapy.
CRM2009-598741.001.jpg
PMC2739437_01_CRM2009-598741.001.jpg
fig1
A small left pleural and pericardial effusions were also evident together with small (1 cm) prevascular and para- tracheal adenopathies (Figure 1). After a partial response with disappearance of the pleural effusion, the malignant process progressed, with bone (Figure 1) and brain metastasis and died 11 months after the initiation of the chemotherapy.
(a) Lymphovascular invasion of lung tissue by adenocarcinoma cells H&Ex200; (b) adenocarcinoma cell in transudative pleural effusion. Cell cluster showing variation in nuclear size, prominent nucleoli and vacuolated cytoplasms. Papanicolaou stainx400.
CRM2009-598741.002.jpg
PMC2739437_01_CRM2009-598741.002.jpg
fig2
An RLL transbronchial lung biopsy showed lymphatic permeation by an adenocarcinoma (Figure 2). Pleural fluid obtained by a left thoracentesis the day before the initiation of that therapy was then an exudate (Table 1), while pleural cytology kept being positive for adenocarcinoma cells (Figure 2).