PMC4939490_01
(A) Chest computed tomography (CT) axial image with contrast enhancement shows a well-defined nodule measuring 2 cm in right middle lobe. There is no calcification and fat component in the nodule (September 2007). (B) In July 2014, chest CT axial image with contrast enhancement display a nodule in right middle lobe. There is no change of nodule size between two CT image. (C) Fused positron emission tomography (PET)/CT image show a nodule with increased 18F-fluorodeoxyglucose uptake (maximum standardized uptake value, 1.7) in right middle lobe (arrow). Histological features of lung mass. H&E stained section of a typical pulmonary carcinoid (D, x200; E, x400). (F) Positive immunohistochemical stain for adrenocorticotropic hormone (x400).
kjim-2014-320f1.jpg
PMC4939490_01_kjim-2014-320f1.jpg
f1-kjim-2014-320
This solitary lung nodule had remained unchanged for 7 years (Fig. 1A). CT scans of her chest, abdomen, and pelvis were normal except for the 2 cm lung nodule (Fig. 1B). ACTH ratio of 1.10 (Table 2). IPSS showed no central to peripheral ACTH gradient and lateralization. A positron emission tomography (PET)-CT scan was performed and increased metabolic activity was detected on the lung nodule (maximum standardized uptake value, 1.7) (Fig. 1C). Immunohistochemistry stains were positive for ACTH, CD56, synaptophysin, and thyroid transcription factor-1 (Fig. 1D-1F).