PMC8249766_01
A CT scan showing a solid lesion with well-defined margins in the anterior segment of the inferior lobe of the right lung.
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F1
To further characterize the lesion, a PET-CT scan with an injection of 18F-fluorodeoxyglucose (FDG) was done; the images showed mild uptake at the level of the nodule in the right lower lobe (with a maximum SUV of 2.8) (Figures 1, 2), suggesting a possibly benign or locally invasive biological behavior.
FDG-PET showing mild contrast uptake at the level of the nodule (SUV max 2.8).
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F2
To further characterize the lesion, a PET-CT scan with an injection of 18F-fluorodeoxyglucose (FDG) was done; the images showed mild uptake at the level of the nodule in the right lower lobe (with a maximum SUV of 2.8) (Figures 1, 2), suggesting a possibly benign or locally invasive biological behavior.
(A) low magnification view of the solid, well-defined intrapulmonary neoformation; (B) cellular growth is limited by the surrounding fibrous septae; (C) the epitheliomorphic ganglion elements are clearly evident with the interposition of some sub-tentacular cells and lymphocytes; (D) largely positive immunocytochemical staining for neuron-specific enolase.
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F3
The tissue specimen analyzed at histology showed richly vascularized intrapulmonary solid proliferation (Figure 3A) that comprised two types of cells: epitheliomorphic and spindle-shaped cells. The former type of cells had large eosinophilic cytoplasm and moderately atypical nuclei (nucleolates) partially dispersed in a loose stroma crossed by ill-defined septa (Figure 3B); the latter cells, also called "sub-tentacular cells," were interposed with moderate infiltrate of lympho-plasma cells (Figure 3C). At immunocytochemistry, all cellular elements showed a strong positive reaction for synaptophysin (Syn) and neuron-specific enolase (Figure 3D), while there were only areas of positivity to the S-100 protein in correspondence of the sub-tentacular elements.