PMC6854985_01
CT scan (axial) showing a large hypoechoic nodule with ill-defined nodular margins. This is suggestive of a solid-cystic nodule in the left thyroid.
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Contrast-enhanced CT scan (Figure 1) showed a 6.4 x 5.6 x 4.9 cm solid-cystic nodule arising from the left thyroid lobe and encasing the left common carotid artery.
CT scan (coronal) showing gross deviation of the common carotid artery. The lack of fat plane suggests involvement of the carotid. The trachea is deviated but is not narrowed.
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The trachea was deviated to the right but there was otherwise no airway narrowing (Figure 2).
CT scan (axial) showing a 4.3 x 3.4 cm spiculated hyperechoic lesion in the left upper lobe abutting the pleura.
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In addition, the CT scan also revealed a 4.3 x 3.4 cm spiculated mass in the left upper lobe of the lung as well as several other smaller subcentimeter lung nodules (Figure 3).
Lung parenchyma infiltrated by poorly differentiated carcinoma with squamoid features. Prominent background desmoplasia is noted.
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This showed atypical squamous cells highly suspected for squamous cell carcinoma (Figure 4).
Tumour cells are diffusely immunoreactive to P40 stain. This finding is indicative of squamous differentiation. Diffuse P40 staining in tumour cells is in keeping with squamous cell carcinoma.
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Immunohistochemistry staining (Figure 5) showed diffuse reactivity to p40, CK7 and paired box 8 (PAX-8) and were negative for Napsin A and thyroid transcription factor-1 (TTF-1).